Covered Entity Details

SCH260097-32 WESTERN MISSOURI MEDICAL CENTER (Active) - information as of 6/6/2025 12:41:51 PM

Main Details

Name

WESTERN MISSOURI MEDICAL CENTER

Subdivision Name

HEART CARE OF WARRENSBURG - WARRENSBURG HEART CARE

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH260097-32

Medicare Provider Number

260097

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/4/2024

Participating Start Date

1/1/2025

Participating Approval Date

10/8/2024

Last Recertification Date

Contacts

Authorizing Official

Western Missouri Medical Center
Dean Ohmart, Chief Financial Officer
(660) 262-7307

Primary Contact

Western Missouri Medical Center
Mary E Chapa, 340B Coordinator
(660) 262-7257

Addresses

Street Address

427 BURKARTH RD
WARRENSBURG, MO 64093

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MO	540421203	1700576196

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
SCH260097-01	Child	SCH	Western Missouri Medical Center	Western Missouri Specialty Services	427-B Burkarth Road	Warrensburg	MO	Terminated
SCH260097-02	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC VI - KNOB NOSTER	600 E. Allen	Knob Noster	MO	Active
SCH260097-03	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	Western Missouri Family Healthcare	807 W. 2nd Street	Holden	MO	Terminated
SCH260097-04	Child	SCH	Western Missouri Medical Center	Western Missouri Women's Health Center	415-A Burkarth Road	Warrensburg	MO	Terminated
SCH260097-05	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	Western Missouri Cardiology	427-A Burkarth Road	Warrensburg	MO	Terminated
SCH260097-06	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	INTERNAL MEDICINE	514 Burkarth Road	Warrensburg	MO	Terminated
SCH260097-07	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	SURGICAL SERVICES	407 Burkarth Rd	Warrensburg	MO	Active
SCH260097-08	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WESTERN MO BONE & JOINT	407 Burkarth Rd	Warrensburg	MO	Active
SCH260097-09	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	AMBC	403 Burkarth	Warrensburg	MO	Terminated
SCH260097-10	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC IV - EXPRESS CARE	427 Burkarth Rd	Warrensburg	MO	Active
SCH260097-11	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	SLEEP STUDY	407 Burkarth Rd	Warrensburg	MO	Active
SCH260097-12	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC - WOMENS HEALTH	415 A Burkarth Rd	Warrensburg	MO	Active
SCH260097-13	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WMMC - Emergency	403 Burkarth Rd	Warrensburg	MO	Terminated
SCH260097-14	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WMMC - Infusion CTR	407 Burkarth Rd	Warrensburg	MO	Terminated
SCH260097-15	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WMMC - Wound Center	403 Burkarth Rd	Warrensburg	MO	Terminated
SCH260097-16	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	PAIN CENTER	407 Burkarth Rd	Warrensburg	MO	Active
SCH260097-17	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WARRENSBURG INTERNAL MEDICINE	511 BURKARTH ROAD	WARRENSBURG	MO	Active
SCH260097-18	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC III - HIGGINSVILLE	1200 West 22nd	Higginsville	MO	Active
SCH260097-19	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC II - WARRENSBURG	513 Burkarth Road	Warrensburg	MO	Active
SCH260097-20	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	EAR NOSE THROAT CLINIC	407 BURKARTH RD STE 302	WARRENSBURG	MO	Active
SCH260097-21	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	SPECIALTY CLINIC (RHEUMATOLOGY & NEPH)	407 BURKARTH RD STE 302	WARRENSBURG	MO	Active
SCH260097-22	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	Western MO Specialty Services - Nephrology	407 BURKARTH RD STE 302	WARRENSBURG	MO	Terminated
SCH260097-23	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	Neurology / .	427 BURKARTH ROAD	WARRENSBURG	MO	Terminated
SCH260097-24	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	PULMONOLOGY	407 Burkarth Rd	WARRENSBURG	MO	Active
SCH260097-25	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	BUILDING BLOCKS PEDIATRICS	510 Foster Lane	WARRENSBURG	MO	Active
SCH260097-26	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	Western MO Specialty Services - Vascular - Vascular	407 Burkarth Rd	WARRENSBURG	MO	Terminated
SCH260097-27	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC V - CFSM	407 E RUSSELL AVE BLDG C	WARRENSBURG	MO	Active
SCH260097-28	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	RURAL HEALTH CLINIC VII - CONCORDIA	905 S MAIN ST	CONCORDIA	MO	Active
SCH260097-29	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	UROLOGY CLINIC - UROLOGY	407 BURKARTH RD	WARRENSBURG	MO	Active
SCH260097-30	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	NON INTERVENTIONAL PAIN MEDICINE - NON INTERVENTIONAL PAIN MEDICINE	407 BURKARTH RD	WARRENSBURG	MO	Terminated
SCH260097-31	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	WESTERN MISSOURI INTERNAL MEDICINE - INTERNAL MEDICINE	502 BURKARTH RD	WARRENSBURG	MO	Active
SCH260097-32	Child	SCH	WESTERN MISSOURI MEDICAL CENTER	HEART CARE OF WARRENSBURG - WARRENSBURG HEART CARE	427 BURKARTH RD	WARRENSBURG	MO	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	1/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Ohmart, Dean Chief Financial Officer Western Missouri Medical Center 6602627307	10/8/2024 7:59 AM
Details	340B ID	Update	New Registration		SCH260097-32	10/8/2024 7:59 AM
Details	Entity Subname	Update	New Registration	HEART CARE OF WARRENSBURG	HEART CARE OF WARRENSBURG - WARRENSBURG HEART CARE	10/8/2024 7:59 AM
Dates	Participating Approval Date	Update	New Registration		10/8/2024 7:59:55 AM	10/8/2024 7:59 AM
Details	State	Update	New Registration	Pending	Approved	10/8/2024 7:59 AM
Dates	Signed By Date	Update	New Registration		10/4/2024 1:58:30 PM	10/8/2024 7:59 AM
Dates	Start Date	Update	New Registration		1/1/2025 12:00:00 AM	10/8/2024 7:59 AM
Addresses	Main Address	Insert	New Registration		427 BURKARTH RD WARRENSBURG, MO 64093	10/4/2024 1:32 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/4/2024 1:32 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		540421203	10/4/2024 1:32 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	10/4/2024 1:32 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1700576196	10/4/2024 1:32 PM
Medicaid Billing	NPI: State	Insert	New Registration		MO	10/4/2024 1:32 PM
Contacts	Primary Contact	Insert	New Registration		Chapa, Mary E 340B Coordinator Western Missouri Medical Center 6602627257	10/4/2024 1:32 PM
Contacts	Authorizing Official	Insert	New Registration		Ohmart, Dean Chief Financial Officer Western Missouri Medical Center 6602627307	10/4/2024 1:32 PM
Details	Assistance Received From Date	Insert	New Registration			10/4/2024 1:32 PM
Details	Assistance Received To Date	Insert	New Registration			10/4/2024 1:32 PM
Details	Last Recertification Date	Insert	New Registration			10/4/2024 1:32 PM
Details	Grant Number	Insert	New Registration			10/4/2024 1:32 PM
Details	340B ID	Insert	New Registration			10/4/2024 1:32 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/4/2024 1:32 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/4/2024 1:32 PM
Details	Medicare Provider Number	Insert	New Registration		260097	10/4/2024 1:32 PM
Details	Entity Name	Insert	New Registration		WESTERN MISSOURI MEDICAL CENTER	10/4/2024 1:32 PM
Details	NOFO Number	Insert	New Registration			10/4/2024 1:32 PM
Details	Program Code	Insert	New Registration		SCH	10/4/2024 1:32 PM
Details	Entity Subname	Insert	New Registration		HEART CARE OF WARRENSBURG	10/4/2024 1:32 PM
Dates	Participating Approval Date	Insert	New Registration			10/4/2024 1:32 PM
Details	State	Insert	New Registration		Pending	10/4/2024 1:32 PM
Dates	Registration Date	Insert	New Registration		10/4/2024 1:32:14 PM	10/4/2024 1:32 PM
Dates	Signed By Date	Insert	New Registration			10/4/2024 1:32 PM
Dates	Start Date	Insert	New Registration			10/4/2024 1:32 PM
Terminations	Termination Comments	Insert	New Registration			10/4/2024 1:32 PM
Terminations	Termination Date	Insert	New Registration			10/4/2024 1:32 PM
Terminations	Termination Effective Date	Insert	New Registration			10/4/2024 1:32 PM
Terminations	Termination Reason	Insert	New Registration			10/4/2024 1:32 PM