No
| Contacts | Signed By | Insert | New Registration | | JONES, CHRIS
CEO
SEMO Health Network
5733132501 | 5/6/2025 7:41 AM |
| Details | 340B ID | Update | New Registration | | CH07137AC | 5/6/2025 7:41 AM |
| Dates | Participating Approval Date | Update | New Registration | | 5/6/2025 7:41:39 AM | 5/6/2025 7:41 AM |
| Details | State | Update | New Registration | Pending | Approved | 5/6/2025 7:41 AM |
| Dates | Signed By Date | Update | New Registration | | 4/15/2025 5:44:38 PM | 5/6/2025 7:41 AM |
| Dates | Start Date | Update | New Registration | | 7/1/2025 12:00:00 AM | 5/6/2025 7:41 AM |
| Addresses | Main Address | Insert | New Registration | |
310 US Highway 61
New Madrid, MO 63869-9753 | 4/15/2025 5:16 PM |
| Addresses | Billing Address | Insert | New Registration | | SEMO Health Network
6738 Missouri 77
Benton, MO 63736 | 4/15/2025 5:16 PM |
| Contacts | Authorizing Official | Insert | New Registration | | JONES, CHRIS
CEO
SEMO Health Network
5733132501 | 4/15/2025 5:16 PM |
| Contacts | Primary Contact | Insert | New Registration | | Matthews, Mallory
Chief Clinical Officer
Southeast Missouri Health Network
5733132500 | 4/15/2025 5:16 PM |
| Details | Assistance Received From Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Assistance Received To Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Grant Number | Insert | New Registration | | H80CS00557 | 4/15/2025 5:16 PM |
| Details | 340B ID | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Entity Name | Insert | New Registration | | SOUTHEAST MISSOURI HEALTH NETWORK | 4/15/2025 5:16 PM |
| Details | NOFO Number | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | Program Code | Insert | New Registration | | CH | 4/15/2025 5:16 PM |
| Details | Entity Subname | Insert | New Registration | | NMCC School Based Health Center | 4/15/2025 5:16 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Details | State | Insert | New Registration | | Pending | 4/15/2025 5:16 PM |
| Dates | Registration Date | Insert | New Registration | | 4/15/2025 5:16:28 PM | 4/15/2025 5:16 PM |
| Dates | Signed By Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Dates | Start Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Terminations | Termination Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 4/15/2025 5:16 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 4/15/2025 5:16 PM |