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NUDAK VENTURES LLC
RWIID503191 Iowa Department of Health and Human Services
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Covered Entity Details
Entity Name
Iowa Department of Health and Human Services
Subdivision Name
RYAN WHITE PART B AIDS ADAP
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID503191
Entity Address
LUCAS STATE OFFICE BLDG
321 E. 12TH ST, 5TH FLOOR
DES MOINES, IA 50319-0075
Grant Number
X07HA00005
Participating Start Date
4/1/1998
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NUDAK VENTURES LLC
Pharmacy Address
NUCARA PHARMACY #27
4927 MAPLE DR
PLEASANT HILL, IA 50327
Pharmacy Comments
01/09/2013 name, address update(was NJL INC. PHARMACY SERVICES 4929 MAPLE DRIVE 50317)
Contract Details
Approval Date
7/1/1999
Contract Begin Date
7/1/1999
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/10/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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