Covered Entity Details

SCH260094-35 COX MEDICAL CENTER BRANSON (Approved) - information as of 5/1/2025 11:44:01 PM

Main Details

Name

COX MEDICAL CENTER BRANSON

Subdivision Name

OUTPATIENT-RHC 4 - COXHEALTH WOMEN'S CENTER

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH260094-35

Medicare Provider Number

260094

Outpatient Facility Provider Number

Additional Details

Current Program Status

Approved

Registration Date

4/2/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/8/2025

Last Recertification Date

Contacts

Authorizing Official

CoxHealth
Jake McWay, SVP - CFO
(417) 269-8811

Primary Contact

CoxHealth
Michelle Hurst, 340B Program Coordinator
(417) 730-6224

Addresses

Street Address

525 Branson Landing Boulevard Suite 408
Branson, MO 65616

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
AR	107967105	1760443980
MO	010932507	1760443980

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
SCH260094-10	Child	SCH	COX MEDICAL CENTER BRANSON	KIMBERLING CITY RADIOLOGY	2 KIMBERLING BOULEVARD	KIMBERLING CITY	MO	Terminated
SCH260094-11	Child	SCH	COX MEDICAL CENTER BRANSON	COXHEALTH CARDIOLOGY	1150 STATE HIGHWAY 248 STE 200	BRANSON	MO	Terminated
SCH260094-12	Child	SCH	COX MEDICAL CENTER BRANSON	DIABETES AND ENDO	1150 STATE HWY 248 STE 102	BRANSON	MO	Terminated
SCH260094-13	Child	SCH	COX MEDICAL CENTER BRANSON	COXHEALTH PAIN AND NEUROLOGY	121 CAHILL ROAD STE 204	BRANSON	MO	Active
SCH260094-14	Child	SCH	COX MEDICAL CENTER BRANSON	STONE CO / OUTREACH THERAPY	2 KIMBERLING BOULEVARD	KIMBERLING CITY	MO	Terminated
SCH260094-15	Child	SCH	COX MEDICAL CENTER BRANSON	KIMERLING CITY / FAMILY MEDICINE	2 KIMBERLING BOULEVARD	KIMBERLING CITY	MO	Terminated
SCH260094-16	Child	SCH	COX MEDICAL CENTER BRANSON	ORTH-NEURO RADIOLOGY	121 CAHILL RD	BRANSON	MO	Terminated
SCH260094-17	Child	SCH	COX MEDICAL CENTER BRANSON	CoxHealth Branson Hills Clinic	1601 Branson Hills Parkway, Suite #100	BRANSON	MO	Active
SCH260094-18	Child	SCH	COX MEDICAL CENTER BRANSON	CMCB FAMILY MEDICINE BRANSON WEST	18452 BUSINESS HWY 13	BRANSON WEST	MO	Active
SCH260094-19	Child	SCH	COX MEDICAL CENTER BRANSON	HYPERBARIC WOUND CARE	101 SKAGGS RD STE 103	BRANSON	MO	Active
SCH260094-20	Child	SCH	COX MEDICAL CENTER BRANSON	CARDIAC REHAB	1150 STATE HWY 248 STE 100	BRANSON	MO	Active
SCH260094-21	Child	SCH	COX MEDICAL CENTER BRANSON	BRANSON THERAPY SERVICES	18452 BUSINESS HWY 13	BRANSON WEST	MO	Terminated
SCH260094-22	Child	SCH	COX MEDICAL CENTER BRANSON	ELECTROCARDIOLOGY	1150 STATE HWY 248	BRANSON	MO	Terminated
SCH260094-23	Child	SCH	COX MEDICAL CENTER BRANSON	TANEY CO OUTREACH THERAPY	121 CAHILL RD STE 101	BRANSON	MO	Terminated
SCH260094-24	Child	SCH	COX MEDICAL CENTER BRANSON	OCCUPATIONAL THERAPY	121 CAHILL RD STE 101	BRANSON	MO	Terminated
SCH260094-25	Child	SCH	COX MEDICAL CENTER BRANSON	SPEECH THERAPY	121 CAHILL RD STE 101	BRANSON	MO	Terminated
SCH260094-26	Child	SCH	COX MEDICAL CENTER BRANSON	CARDIAC DIAGNOSTICS	1150 STATE HWY 248	BRANSON	MO	Active
SCH260094-27	Child	SCH	COX MEDICAL CENTER BRANSON	BRANSON WEST RADIOLOGY	18452 BUSINESS HWY 13	BRANSON WEST	MO	Active
SCH260094-28	Child	SCH	COX MEDICAL CENTER BRANSON	MRI	121 CAHILL RD STE 202	BRANSON	MO	Terminated
SCH260094-29	Child	SCH	COX MEDICAL CENTER BRANSON	Ambulatory Infusion Center	525 Branson Landing Blvd	Branson	MO	Terminated
SCH260094-30	Child	SCH	COX MEDICAL CENTER BRANSON	Radiation Oncology	525 Branson Landing Blvd	Branson	MO	Terminated
SCH260094-31	Child	SCH	COX MEDICAL CENTER BRANSON	Oncology	525 Branson Landing Blvd	Branson	MO	Terminated
SCH260094-32	Child	SCH	COX MEDICAL CENTER BRANSON	Womens Imaging Center	525 Branson Landing Blvd Ste 404	Branson	MO	Terminated
SCH260094-33	Child	SCH	COX MEDICAL CENTER BRANSON	CMCB Family Medicine & OB	525 Branson Landing Blvd Ste 508	Branson	MO	Active
SCH260094-34	Child	SCH	COX MEDICAL CENTER BRANSON	COX HEART CENTER BRANSON - CARDIOLOGY	1150 STATE HWY 248 STE 200	BRANSON	MO	Active
SCH260094-35	Child	SCH	COX MEDICAL CENTER BRANSON	OUTPATIENT-RHC 4 - COXHEALTH WOMEN'S CENTER	525 Branson Landing Boulevard Suite 408	Branson	MO	Approved
SCH260094-36	Child	SCH	COX MEDICAL CENTER BRANSON	OUTPATIENT RHC-3 - CMCB FAMILY MED FORSYTH	13852 US-160	Forsyth	MO	Approved

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		McWay, Jake SVP - CFO CoxHealth 4172698811	4/8/2025 1:15 PM
Details	340B ID	Update	New Registration		SCH260094-35	4/8/2025 1:15 PM
Details	Entity Subname	Update	New Registration	OUTPATIENT-RHC 4	OUTPATIENT-RHC 4 - COXHEALTH WOMEN'S CENTER	4/8/2025 1:15 PM
Dates	Participating Approval Date	Update	New Registration		4/8/2025 1:15:22 PM	4/8/2025 1:15 PM
Details	State	Update	New Registration	Pending	Approved	4/8/2025 1:15 PM
Dates	Signed By Date	Update	New Registration		4/4/2025 9:36:38 AM	4/8/2025 1:15 PM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/8/2025 1:15 PM
Addresses	Main Address	Insert	New Registration		525 Branson Landing Boulevard Suite 408 Branson, MO 65616	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		107967105	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		AR	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		010932507	4/2/2025 2:07 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	4/2/2025 2:07 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1760443980	4/2/2025 2:07 PM
Medicaid Billing	NPI: State	Insert	New Registration		AR	4/2/2025 2:07 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1760443980	4/2/2025 2:07 PM
Medicaid Billing	NPI: State	Insert	New Registration		MO	4/2/2025 2:07 PM
Contacts	Authorizing Official	Insert	New Registration		McWay, Jake SVP - CFO CoxHealth 4172698811	4/2/2025 2:07 PM
Contacts	Primary Contact	Insert	New Registration		Hurst, Michelle 340B Program Coordinator CoxHealth 4177306224	4/2/2025 2:07 PM
Details	Assistance Received From Date	Insert	New Registration			4/2/2025 2:07 PM
Details	Assistance Received To Date	Insert	New Registration			4/2/2025 2:07 PM
Details	Last Recertification Date	Insert	New Registration			4/2/2025 2:07 PM
Details	Grant Number	Insert	New Registration			4/2/2025 2:07 PM
Details	340B ID	Insert	New Registration			4/2/2025 2:07 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/2/2025 2:07 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/2/2025 2:07 PM
Details	Medicare Provider Number	Insert	New Registration		260094	4/2/2025 2:07 PM
Details	Entity Name	Insert	New Registration		COX MEDICAL CENTER BRANSON	4/2/2025 2:07 PM
Details	NOFO Number	Insert	New Registration			4/2/2025 2:07 PM
Details	Program Code	Insert	New Registration		SCH	4/2/2025 2:07 PM
Details	Entity Subname	Insert	New Registration		OUTPATIENT-RHC 4	4/2/2025 2:07 PM
Dates	Participating Approval Date	Insert	New Registration			4/2/2025 2:07 PM
Details	State	Insert	New Registration		Pending	4/2/2025 2:07 PM
Dates	Registration Date	Insert	New Registration		4/2/2025 2:07:46 PM	4/2/2025 2:07 PM
Dates	Signed By Date	Insert	New Registration			4/2/2025 2:07 PM
Dates	Start Date	Insert	New Registration			4/2/2025 2:07 PM
Terminations	Termination Comments	Insert	New Registration			4/2/2025 2:07 PM
Terminations	Termination Date	Insert	New Registration			4/2/2025 2:07 PM
Terminations	Termination Effective Date	Insert	New Registration			4/2/2025 2:07 PM
Terminations	Termination Reason	Insert	New Registration			4/2/2025 2:07 PM