340B Drug Pricing Program Database


DSH170040 UNIVERSITY OF KANSAS HOSPITAL (Active) - information as of 6/16/2025 11:19:26 PM

Main Details
UNIVERSITY OF KANSAS HOSPITAL
Disproportionate Share Hospital
Yes
DSH170040
170040


Additional Details
Active
9/7/2007
10/1/2000
9/7/2007
9/6/2024

Contacts

University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301

The University of Kansas Hospital
Todd Holt, Pharmacy Operations Manager
(913) 945-8291

Addresses

4000 Cambridge Street
Kansas City, KS 66160

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
12/8/04 UPDATED MEDICAID #(WAS 6086212101)01/21/2010
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
MO010567808,600072985,600072842,600074046,600074047,600567804,606093706,600010163,6000498871063795896,1093003675,1265921506,1417245192,1457335036,1538726880,1649259656,1700395878,1962911693
KS30003935830035,30003935830030,30003935830039,30003935830004,30003935830005,30003935830010,30003935830009,30003935830049,300039358300031457335036,1093003675,1417245192,1063795896,1700395878,1962911693,1265921506,1649259656,1538726880
Shipping Addresses

The University of Kansas Health System Bell- (Inpatient)
2015 WEST 39TH STREET
B421
KANSAS CITY, KS 66103

University of Kansas Hospital Home Infusion
11300 Corporate Avenue
Suite 160
Lenexa, KS 66219

University of Kansas Hospital Southlake Retail
11300 Corporate Avenue
Suite 120
Lenexa, KS 66219

The University of Kansas-Cambridge Inpatient
3825 Cambridge Street
Suite 1370
Kansas City, KS 66103

Kansas City Cancer Center SW University of Kansas
12200 W 110th Street
Overland Park, KS 66210

University of Kansas Hospital Authority Cancer Center Pharmacy East
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064

The University of Kansas Health System Indian Creek- (Inpatient Pharmacy)
10710 Nall Ave
1302
Overland Park, KS 66211

University of Kansas Hospital Authority Cancer Center Pharmacy South
1000 E 101st TERRACE
Kansas City, MO 64131

University of Kansas Hospital Authority Cancer Center Pharmacy North
8700 N Green Hills Rd
Kansas City, MO 64154

University of KS Hospital Southlake Warehouse
11300 Corporate Ave
180
Lenexa, KS 66219

Safecor
4060 Business Park Drive
Columbus, OH 43204

Clinical Research Center
4350 Shawnee Mission Parkway
2119
Fairway, KS 66205

The University of Kansas Health System Bell Hospital Tower (Retail Pharmacy)
2015 W. 39th Ave
G401
Kansas City, KS 66103

University of Kansas Hospital Cambridge Retail Pharmacy
3825 Cambridge Street
Suite 1333
Kansas City, KS 66103

University of Kansas Hospital Cancer Center Pharmacy
2330 Shawnee Mission Pkwy
Westwood, KS 66205

University of Kansas Hospital-Southlake Shared Services
11300 Corporate Ave
Suite 170
Lenexa, KS 66219

University of Kansas Hospital Westwood Infusion
2330 SHAWNEE MISSION PKWY
Suite 3301
WESTWOOD, KS 66205

TUKHS-Strawberry Hill Campus Hospital
901 N. 5th Street
Kansas City, KS 66101

The University of Kansas Health System Indian Creek Retail Pharmacy
10710 Nall Ave
Suite 1301
Overland Park, KS 66211

Olathe Health Cancer Center Pharmacy
15123 S. OMC Parkway
Olathe, KS 66061

TUKHS-Olathe Infusion Pharmacy
20375 W 151st S
Suite 208
Olathe, KS 66061
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/11/201707/01/2017  05/24/2017
Contract DetailACCREDO HEALTH GROUP INC201 GREAT CIRCLE ROAD
NASHVILLETN3722804/11/201707/01/2017 04/09/201804/13/2018
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/11/201707/01/2017  05/24/2017
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/11/201707/01/2017  05/24/2017
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624104/11/201707/01/2017 07/01/202303/05/2024
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/11/201707/01/2017  05/24/2017
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349204/11/201707/01/2017  05/24/2017
Contract DetailACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607501/10/202204/01/2022  04/01/2022
Contract DetailAETNA SPECIALTY PHARMACY, LLC503 SUNPORT LN
ORLANDOFL32809-787407/15/201910/01/2019 08/19/202109/07/2021
Contract DetailAMBER ENTERPRISES, INCDBA AMBER SPECIALTY PHARMACY 1 E ERIE ST STE 630
CHICAGOIL6061110/15/201901/01/2020  01/01/2020
Contract DetailAMBER PHARMACYAMBER ENTERPRISES, INC. 10004 S 152ND STREET
SUITE A 		OMAHANE68138-393110/15/201901/01/2020  01/01/2020
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/11/201704/01/2017  05/24/2017
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/05/202104/01/2021  04/01/2021
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/12/202110/01/2021  10/01/2021
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/12/202110/01/2021  10/01/2021
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/05/202104/01/2021  04/01/2021
Contract DetailCYSTIC FIBROSIS SERVICESCYSTIC FIBROSIS SERVICES, INC 10530 JOHN W ELLIOTT DR, STE 200
FRISCOTX7503301/14/201604/01/2016 08/09/201708/11/2017
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503306/29/201707/01/2017  06/29/2017
Contract DetailDIPLOMAT SPECIALTY INFUSION GROUPACCURATE RX PHARMACY CONSULTING, LLC 103 CORPORATE LAKE DR STE B
COLUMBIAMO65203-729010/15/202101/01/2022 09/06/202209/06/2022
Contract DetailDIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268303/01/201304/01/2013 07/07/202207/07/2022
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/15/201901/01/2020  01/01/2020
Contract DetailHY VEE PHARMACY6655 MARTWAY
MISSIONKS6620210/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE7620 STATELINE
PRAIRIE VILLAGEKS6620810/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE FOOD STORESHY-VEE PHARMACY 109 N. BLUE JAY DR
LIBERTYMO6406807/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE INCDBA: HY-VEE PHARMACY #2 #1509 8900 W. 135TH
OVERLAND PARKKS6622107/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY13550 WEST 63RD STREET
SHAWNEEKS6621610/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE PHARMACY7117 N. PROSPECT
GLADSTONEMO6411907/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY1525 E. 23RD STREET S
INDEPENDENCEMO6405507/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY #1 (1320)8301 N. ST.CLAIR
KANSAS CITYMO6415107/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY #146314955 W 151ST STREET
OLATHEKS6606207/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY #15088501 WEST 95TH STREET
OVERLAND PARKKS6621210/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE PHARMACY #2 (1261)4545 SOUTH NOLAND RD
INDEPENDENCEMO6405507/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY (1034)HY-VEE INC 1307 EAST NORTH AVE
BELTONMO6401207/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY (1542)9400 EAST 350 HIGHWAY
RAYTOWNMO6413307/15/202210/01/2022  10/01/2022
Contract DetailHY-VEE PHARMACY 146418101 W. 119TH STREET
OLATHEKS6606107/15/202210/01/2022  10/01/2022
Contract DetailHy-Vee Pharmacy Fulfillment Center #4016Hy-Vee Inc 4707 Fleur Dr
Des MoinesIA5032110/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE PHARMACY SOLUTIONSHYVACS, LLC 10004 S. 152ND ST., SUITE C
OMAHANE6813810/15/201901/01/2020  01/01/2020
Contract DetailHY-VEE, INC.DBA HY-VEE PHARMACY #1322 5330 NW 64TH STREET
KANSAS CITYMO6415110/15/201901/01/2020  01/01/2020
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08603 3750 STATE AVENUE
KANSAS CITYKS6610202/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08608 4645 SHAWNEE DR.
KANSAS CITYKS6610602/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08584 950 MINNESOTA AVE.
KANSAS CITYKS6610102/25/201304/01/2013 03/27/202504/09/2025
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 8919 4300 RAINBOW BLVD.
KANSAS CITYKS6610302/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08600 8101 STATE AVE.
KANSAS CITYKS6611202/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08582 8800 W. 95TH STREET
OVERLAND PARKKS6621202/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08580 6510 NIEMAN RD.
SHAWNEEKS6620302/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05272 6300 JOHNSON DR
MISSIONKS6620202/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08599 5170 ROE BLVD.
ROELAND PARKKS6620502/25/201304/01/2013 07/31/202110/15/2021
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05265 13502 WEST 87TH STREET PARKWAY
LENEXAKS6621502/25/201304/01/2013  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05261 8200 MISSION ROAD
PRAIRIE VILLAGEKS6620804/20/201507/01/2015  05/24/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08601 12290 W. COLLEGE BLVD.
OVERLAND PARKKS6621010/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08585 12691 ANTIOCH RD
OVERLAND PARKKS6621310/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05156 18351 W. 119TH ST.
OLATHEKS6606110/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05274 1075 W. SANTA FE STREET
OLATHEKS6606110/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08573 11900 W 135TH STREET
OVERLAND PARKKS6622110/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08588 11729 ROE AVE.
LEAWOODKS6621110/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08586 7100 W. 151ST STREET
OVERLAND PARKKS6622310/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05268 390 LIMIT ST
LEAVENWORTHKS6604810/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08606 9521 MISSION RD.
OVERLAND PARKKS6620610/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08602 7501 METCALF AVE
OVERLAND PARKKS6620410/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08237 5001 W. 135TH ST.
LEAWOODKS6622410/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05257 1785 S MUR LEN RD
OLATHEKS6606210/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04521 22700 W. 55TH TERRACE
SHAWNEEKS6622610/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04323 10050 WOODLAND RD.
LENEXAKS6622010/10/201701/01/2018  10/10/2017
Contract DetailKANSAS CVS PHARMACY, L.L.C.CVS PHARMACY # 17299 10900 STADIUM PKWY
KANSAS CITYKS6611107/12/202110/01/2021  10/01/2021
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00676 2300 IOWA ST.
LAWRENCEKS6604604/08/202207/01/2022  07/01/2022
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05266 13438 W 62ND TER
SHAWNEEKS6621604/08/202207/01/2022 07/13/202307/13/2023
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05271 9501 NALL AVE.
OVERLAND PARKKS6620704/08/202207/01/2022  07/01/2022
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05889 400 SOUTH 10TH ST.
ATCHISONKS6600204/08/202207/01/2022  07/01/2022
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08605 2835 SW WANAMAKER RD.
TOPEKAKS6661404/08/202207/01/2022 03/05/202504/09/2025
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #10075 4808 EAST CENTRAL AVENUE
WICHITAKS6720804/08/202207/01/2022 05/01/202505/01/2025
Contract DetailKANSAS CVS PHARMACY, L.L.C.CVS/PHARMACY #10862 110 WEST MAIN ST.
GARDNERKS6603004/08/202207/01/2022  07/01/2022
Contract DetailKANSAS CVS PHARMACY, L.L.C.CVS PHARMACY # 16885 15700 SHAWNEE MISSION PKWY
SHAWNEEKS6621704/08/202207/01/2022  07/01/2022
Contract DetailKANSAS CVS PHARMACY, L.L.C.CVS PHARMACY # 16883 15345 W 119TH ST
OLATHEKS6606204/15/202407/01/2024  07/01/2024
Contract DetailKANSAS CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #10244 3901 SW 21ST ST.
TOPEKAKS6660404/09/202507/01/2025  04/09/2025
Contract DetailLUMICERA HEALTH SERVICES, LLC310 INTEGRITY DRIVE
MADISONWI53717-149907/13/202310/01/2023  10/01/2023
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05697 3902 MAIN ST
KANSAS CITYMO6411104/20/201507/01/2015  05/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08567 5011 MAIN ST.
KANSAS CITYMO6411204/20/201507/01/2015  05/24/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08577 4400 NW BARRY ROAD
KANSAS CITYMO6415410/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05678 7907 STATE LINE RD
KANSAS CITYMO6411410/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05663 6244 BROOKSIDE BLVD
KANSAS CITYMO6411310/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05655 1901 WEST KANSAS ST.
LIBERTYMO6406810/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08556 5440 NW 64TH ST.
KANSAS CITYMO6415110/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05698 7107 N OAK TRAFFIC WAY
GLADSTONEMO6411810/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08590 315 W 75TH STREET
KANSAS CITYMO6411410/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05724 13101 STATE LINE RD
KANSAS CITYMO6414510/10/201701/01/2018  10/10/2017
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08555 4990 NE VIVION RD.
KANSAS CITYMO6411907/12/202110/01/2021  10/01/2021
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08596 601 S. JEFFERSON ST.
KEARNEYMO6406007/12/202110/01/2021  10/01/2021
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08598 9005 EAST 350 HIGHWAY
RAYTOWNMO6413307/12/202110/01/2021  10/01/2021
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04088 3351 SW 3RD ST.
LEES SUMMITMO6408104/08/202207/01/2022 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05635 11124 HOLMES RD
KANSAS CITYMO6413104/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05645 930 N BELT HWY
SAINT JOSEPHMO6450604/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05661 409 E NORTH AVE
BELTONMO6401204/08/202207/01/2022 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05691 11115 E US HWY 24 HWY
INDEPENDENCEMO6405404/08/202207/01/2022 03/21/202403/21/2024
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05719 621 SW 3RD STREET
LEES SUMMITMO6406304/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05727 1301 PLATTE FALLS RD
PLATTE CITYMO6407904/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08430 3825 S. NOLAND RD.
INDEPENDENCEMO6405504/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08543 1914 SWIFT
N. KANSAS CITYMO6411604/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08553 10205 STATE LINE RD.
KANSAS CITYMO6411404/08/202207/01/2022 07/13/202307/13/2023
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08554 6129 NE. ANTIOCH RD.
GLADSTONEMO6411904/08/202207/01/2022 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08563 300 S. COMMERIAL ST
HARRISONVILLEMO6470104/08/202207/01/2022 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08565 330 N.E. BARRY RD.
KANSAS CITYMO6415504/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08570 1616 N 7 HWY
BLUE SPRINGSMO6401404/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08579 751 NE WOODS CHAPEL ROAD
LEES SUMMITMO6406404/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08581 3201 SOUTH 7 HIGHWAY
BLUE SPRINGSMO6401404/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08592 921 MAIN
KANSAS CITYMO6410504/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08595 1215 WEST FOXWOOD DR.
RAYMOREMO6408304/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08607 12000 S. 71 HWY.
GRANDVIEWMO6403004/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10152 1501 E. OHIO ST.
CLINTONMO6473504/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10241 1315 WEST 23RD ST.
INDEPENDENCEMO6405004/08/202207/01/2022  07/01/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.CVS PHARMACY # 16731 1850 NW CHIPMAN RD
LEES SUMMITMO6408104/08/202207/01/2022 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05693 8421 NW PRAIRIE VIEW RD.
KANSAS CITYMO6415304/15/202407/01/2024  07/01/2024
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08578 6300 PROSPECT AVE
KANSAS CITYMO6413204/15/202407/01/2024 05/01/202505/01/2025
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #11309 1018 N JESSE JAMES RD
EXCELSIOR SPRINGSMO6402404/15/202407/01/2024 05/01/202505/01/2025
Contract DetailONCO360SINA DRUG, LLC 4700 W SAM HOUSTON PKWY N
STE 150 		HOUSTONTX7704104/07/202507/01/2025  04/07/2025
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191310/11/201901/01/2020 01/05/202101/05/2021
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191307/14/202310/01/2023  10/01/2023
Contract DetailOPTUM FRONTIER THERAPIES, LLC325 W ATHERTON RD SUITE 1
FLINTMI48507-260107/14/202310/01/2023  10/01/2023
Contract DetailOPTUM INFUSION SERVICES 305, LLC15529 COLLEGE BLVD.
LENEXAKS66219-135107/15/202008/28/2020  08/28/2020
Contract DetailOPTUM INFUSION SERVICES 501, INC.1867 LACKLAND HILL PKWY
SAINT LOUISMO6314609/06/202209/07/2022  09/07/2022
Contract DetailOPTUM PHARMACY 700, LLC5700 DOT COM CT, STE 1000
OVIEDOFL3276510/15/202101/01/2022  01/01/2022
Contract DetailOPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705807/14/202310/01/2023  10/01/2023
Contract DetailOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/08/202204/08/2022  04/11/2022
Contract DetailOPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520407/14/202310/01/2023  10/01/2023
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/11/201901/01/2020  01/01/2020
Contract DetailOPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824910/15/202101/01/2022  01/01/2022
Contract DetailOPTUM PHARMACY 705, LLC11142 RENNER BLVD
LENEXAKS6621910/11/201901/01/2020 06/18/202107/12/2021
Contract DetailOPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265510/15/202101/01/2022  01/01/2022
Contract DetailOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729810/15/202101/01/2022  01/01/2022
Contract DetailOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508510/11/201901/01/2020  01/01/2020
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983807/15/202008/28/2020  08/28/2020
Contract DetailOPTUMRX2858 LOKER AVE E STE 100
CARLSBADCA92010-660810/15/202101/01/2022 09/01/202209/01/2022
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999207/20/201710/01/2017 10/01/202210/03/2022
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/11/201704/01/2017  05/24/2017
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/05/202104/01/2021 04/01/202504/01/2025
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/05/202104/01/2021 04/01/202504/01/2025
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/05/202104/01/2021 04/01/202504/01/2025
Contract DetailQUALITY DRUG CLINICAL CARE4 TECHNOLOGY DR STE 100
IRVINECA9261807/13/202310/01/2023  10/01/2023
Contract DetailSINA DRUG LLCD/B/A ONCO 360 13410 EASTPOINT CENTRE DR
STE 101 		LOUISVILLEKY4022304/07/202507/01/2025  04/07/2025
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738607/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-00265000 10TH AVE
LEAVENWORTHKS6604807/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-048612801 KANSAS AVE
BONNER SPRINGSKS6601207/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-057713600 SO. ALDEN STREET
OLATHEKS6606207/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-109410300 E HWY 350
RAYTOWNMO6413807/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-11207207 NORTH M-1 HWY
GLADSTONEMO6411907/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-115110824 PARALLEL PARKWAY
KANSAS CITYKS6610907/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-16917701 FRONTAGE ROAD
OVERLAND PARKKS6620407/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-24905150 ROE AVE
ROELAND PARKKS6620507/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-285516100 W 65TH STREET
SHAWNEEKS6621707/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-28578551 N. BOARDWALK AVENUE
KANSAS CITY (NW)MO6415407/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-29551701 WEST 133RD STREET
KANSAS CITYMO6414507/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-327315700 METCALF AVE
OVERLAND PARKKS6622307/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-4475395 N. K 7 HWY
OLATHEKS6606107/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-518010303 METCALF AVE
OVERLAND PARK (MTCL)KS6621207/14/202210/01/2022 10/25/202310/25/2023
Contract DetailWAL-MART PHARMACY 10-52079000 METCALF AVE
OVERLAND PARKKS6621207/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-530811010 WEST 74TH TERRACE
SHAWNEE (NIEMAN)KS6620307/14/202210/01/2022  10/01/2022
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283707/14/202210/01/2022  10/01/2022
Contract DetailWALGREEN CODBA: WALGREENS #11087 1214 W. FOXWOOD DRIVE
RAYMOREMO64083-830010/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #11167 1502 INDUSTRIAL ROAD
EMPORIAKS66801-622010/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #10125 2850 STATE AVENUE
KANSAS CITYKS6610210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #11930 3545 BROADWAY
KANSAS CITYMO6411110/24/201210/24/2012 09/12/201909/12/2019
Contract DetailWALGREEN CODBA; WALGREENS #12153 358 E HWY 69
KANSAS CITYMO64119-311710/24/201210/24/2012 11/14/202201/05/2023
Contract DetailWALGREEN CODBA: WALGREENS #11925 400 S. BROADWAY
OAK GROVEMO6407510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #10725 4022 N BELT HIGHWAY
SAINT JOSEPHMO6450610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #09425 5455 ROBERTS ST
SHAWNEEKS6622610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CODBA: WALGREENS #12922 550 S 129TH ST
BONNER SPRINGSKS6601210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07778 1001 SW GAGE BLVD
TOPEKAKS66604-170010/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 03069 1001 SW TOPEKA BLVD.
TOPEKAKS6661210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04210 1100 E. 63RD ST.
KANSAS CITYMO6411010/24/201210/24/2012 01/23/202501/23/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 05263 11021 SHAWNEE MISSION PKWY
SHAWNEEKS6620310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #11924 11830 W. 75TH ST
SHAWNEEKS6621410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04439 1191 W KANSAS ST
LIBERTYMO6406810/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 09424 12601 PFLUMM RD
OVERLAND PARKKS6621310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 01236 13000 S HIGHWAY 71
GRANDVIEWMO64030-251510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04665 13450 S. BLACKBOB RD.
OLATHEKS6606210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05277 1400 E NORTH AVE
BELTONMO6401210/24/201210/24/2012 01/23/202501/23/2025
Contract DetailWALGREEN CO.DBA: WALGREENS # 09376 1445 S MAIN STREET
OTTAWAKS66067-352810/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12815 1453 E. 151ST ST
OLATHEKS6606210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06112 15066 W 151ST ST
OLATHEKS66062-300010/24/201210/24/2012 04/08/202407/10/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 04186 15100 W. 87TH
LENEXAKS6621910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04224 1536 E. 23RD STREET S
INDEPENDENCEMO64055-165710/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04225 1701 NW ST RTE 7
BLUE SPRINGSMO6401410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05873 17811 E US HWY 24
INDEPENDENCEMO6405610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04182 1801 E LANGSFORD RD
LEES SUMMITMO6406310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 09049 1911 N BROADWAY STREET
PITTSBURGKS66762-281110/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04557 2121 SW FAIRLAWN ROAD
TOPEKAKS6661410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04236 2261 S STERLING AVE
INDEPENDENCEMO6405210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 10845 2301 HOLMES STREET
KANSAS CITYMO64108-264010/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA; WALGREENS #12925 2301 RUNNING HORSE RD
PLATTE CITYMO6407910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04212 2501 E LINWOOD BLVD
KANSAS CITYMO6412810/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07551 2620 S BELT HIGHWAY
ST JOSEPHMO64503-164610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04406 2630 NE VIVION RD.
KANSAS CITYMO6411910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12923 2900 S 4TH ST
LEAVENWORTHKS66048-500210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 03772 2901 SE CALIFORNIA AVE
TOPEKAKS6660510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 16314 3900 SW 29TH ST
TOPEKAKS6661410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.WALGREENS # 07789 3200 S 7 HWY
BLUE SPRINGSMO6401410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07060 325 BLUEMONT AVE
MANHATTANKS66502-572310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 02450 330 SW WARD ROAD
LEES SUMMITMO64081-244510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 03055 3421 WEST 6TH ST
LAWRENCEKS6604910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04981 3630 SW WANAMAKER RD.
TOPEKAKS6661410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04466 3645 FREDERICK AVENUE
ST JOSEPHMO6450610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04782 3696 SW TOPEKA BLVD
TOPEKAKS6661110/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05278 3845 BROADWAY
KANSAS CITYMO6411110/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05247 3915 S NOLAND RD
INDEPENDENCEMO6405510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 03056 400 WEST 23RD STREET
LAWRENCEKS6604610/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04204 401 NE BARRY ROAD
KANSAS CITYMO6415510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #13032 4016 W 95TH STREET
PRAIRIE VILLAGEKS6620710/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04211 4630 TROOST AVE.
KANSAS CITYMO6411010/24/201210/24/2012 11/16/202201/05/2023
Contract DetailWALGREEN CO.DBA: WALGREENS # 04185 4951 ROE BLVD.
ROELAND PARKKS6620510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12778 505 S COMMERCIAL ST
HARRISONVILLEMO6470110/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 09985 5230 W 151ST STREET
LEAWOODKS6622410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04222 5400 INDEPENDENCE AVE
KANSAS CITYMO64123-202710/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04183 545 E. SANTA FE ST
OLATHEKS6606110/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 01235 621 N MAGUIRE ST
WARRENSBURGMO64093-141910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 10130 6365 LEWIS DR
PARKVILLEMO64152-369910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 10150 750 E MAIN STREET
GARDNERKS66030-174410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04234 7500 METCALF AVE
OVERLAND PARKKS6620410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04235 7500 WORNALL RD.
KANSAS CITYMO6411410/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07550 7739 STATE AVE
KANSAS CITYKS66112-281910/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04221 8450 W 151ST STREET
OVERLAND PARKKS6622310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06920 8681 W 135TH ST
OVERLAND PARKKS66223-121510/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 06478 8701 JOHNSON DRIVE
MERRIAMKS6620210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 05357 9300 E. GREGORY BLVD.
RAYTOWNMO6413310/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 04530 9430 BLUE RIDGE BLVD.
KANSAS CITYMO6413810/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #11370 9500 ANTIOCH RD
OVERLAND PARKKS6621210/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA: WALGREENS #12114 9700 N CEDAR AVE
KANSAS CITYMO6415710/24/201210/24/2012  05/24/2017
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16072 3537 BROADWAY BLVD
KANSAS CITYMO6411104/10/201407/01/2014  05/24/2017
Contract DetailWalgreens Central Fill #213942601 Hughes Road
Suite 103 		LibertyMO6406807/13/202310/01/2023  10/01/2023
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/24/201210/24/2012 09/12/201909/12/2019
Contract DetailWALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904904/25/201307/01/2013 08/17/201505/24/2017
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527504/20/201507/01/2015  05/24/2017
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700804/20/201507/01/2015 10/01/202110/15/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818804/20/201507/01/2015  05/24/2017
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503304/20/201507/01/2015  05/24/2017
Contract DetailWALMART PHARMACY 10-09984701 MISSION RD.
WESTWOODKS6620507/14/202210/01/2022  10/01/2022
Contract DetailWALMART PHARMACY 10-24425261 NORTH ANTIOCH ROAD
KANSAS CITYMO6411907/14/202210/01/2022  10/01/2022
Contract DetailWALMART PHARMACY 10-46115701 SILVERHEEL ST.
SHAWNEEKS6622607/14/202210/01/2022  10/01/2022
Contract DetailWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/18/202404/01/2024  04/01/2024
Contract DetailWALMART PHARMACY 10-61722300 METROPOLITAN AVE
KANSAS CITYKS6610607/14/202210/01/2022  10/01/2022
Contract DetailWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/18/202404/01/2024  04/01/2024
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH170040AChildDSHUNIVERSITY OF KANSAS HOSPITALCC-CLINIC EXAM2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040AAChildDSHKANSAS UNIVERSITY HOSPITALIndian Creek Surgery Clinic10730 Nall AvenueOverland ParkKSTerminated
DSH170040ABChildDSHKANSAS UNIVERSITY HOSPITALMATCS ICC / MATCS - Lung Nodule10730 NALL AVEOVERLAND PARKKSTerminated
DSH170040ACChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Sarcoma Exam ICC10730 Nall Ave.Overland ParkKSActive
DSH170040ADChildDSHKANSAS UNIVERSITY HOSPITALKUCC ICC-BREAST SURG EXAM10787 NALL AVEOVERLAND PARKKSTerminated
DSH170040AEChildDSHUNIVERSITY OF KANSAS HOSPITALUNIV OF KS HOSPITAL NEUROPSYCHOLOGY - Neuropsychology Services4330 Shawnee Mission Pkwy.FairwayKSActive
DSH170040AFChildDSHKANSAS UNIVERSITY HOSPITALUNIV OF KS HOSP INDIAN CREEK CAMPUS - ICC PAIN MANAGEMENT10720 NALL AVEOVERLAND PARKKSTerminated
DSH170040AGChildDSHUNIVERSITY OF KANSAS HOSPITALPeriop Services ICC10710 Nall Ave.Overland ParkKSActive
DSH170040AHChildDSHUNIVERSITY OF KANSAS HOSPITALUNIV OF KS HOSP INDIAN CREEK CAMPUS - ICC GI ENDOSCOPY10710 NALL AVEOVERLAND PARKKSTerminated
DSH170040AJChildDSHUNIVERSITY OF KANSAS HOSPITALInterventional Radiology ICC10710 Nall Ave.Overland ParkKSActive
DSH170040AKChildDSHKANSAS UNIVERSITY HOSPITALUNIV OF KANSAS CANCER CENTER SOUTH - KUCC SOUTH-DIAG RADIOLOGY1000 E 101ST TERKANSAS CITYMOTerminated
DSH170040ALChildDSHKANSAS UNIVERSITY HOSPITALSOUTH KANSAS CITY MEDICAL PAVILION - SKC Med Pav-Rad Ther1000 E 101ST TERKANSAS CITYMOTerminated
DSH170040AMChildDSHUNIVERSITY OF KANSAS HOSPITALSKC Med Pavilion Treatment1000 E. 101st TerraceKansas CityMOActive
DSH170040ANChildDSHUNIVERSITY OF KANSAS HOSPITALLaboratory SKCMP1000 E. 101st TerraceKansas CityMOActive
DSH170040APChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV OPK10787 Nall Ave.Overland ParkKSActive
DSH170040AQChildDSHUNIVERSITY OF KANSAS HOSPITALCV Heart Rhythm Mgmt OPK10787 Nall Ave.Overland ParkKSActive
DSH170040ARChildDSHUNIVERSITY OF KANSAS HOSPITALCV Nuclear OPK10787 Nall Ave.Overland ParkKSActive
DSH170040ASChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc OPK12200 W. 110th StreetOverland ParkKSActive
DSH170040ATChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment OPK12200 W. 110th StreetOverland ParkKSActive
DSH170040AUChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Rad Therapy OPK12200 W. 110th StreetOverland ParkKSActive
DSH170040AVChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Laboratory OPK12200 W. 110th StreetOverland ParkKSActive
DSH170040AWChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV Liberty1530 N. Church RoadLibertyMOActive
DSH170040AXChildDSHUNIVERSITY OF KANSAS HOSPITALCV Nuclear Liberty1530 N. Church RoadLibertyMOActive
DSH170040AYChildDSHUNIVERSITY OF KANSAS HOSPITALCV Heart Rhythm Mgmt Liberty1530 N. Church RoadLibertyMOActive
DSH170040AZChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc Westwood2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040BAChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Laboratory WW2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040BBChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Breast Center Westwood2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040BCChildDSHUNIVERSITY OF KANSAS HOSPITALBMT EXAM Westwood2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040BDChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment Westwood2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040BEChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment NKC2750 Clay Edwards DriveNorth Kansas CityMOTerminated
DSH170040BFChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV LVN3601 S. 4th St.LeavenworthKSActive
DSH170040BGChildDSHUNIVERSITY OF KANSAS HOSPITALCV Heart Rhythm Mgmt LVN3601 S. 4th St.LeavenworthKSTerminated
DSH170040BHChildDSHUNIVERSITY OF KANSAS HOSPITALUKH Cancer Rad Therapy4001 Rainbow BlvdKansas CityKSActive
DSH170040BJChildDSHUNIVERSITY OF KANSAS HOSPITALCRC Lab4350 Shawnee Mission Pkwy.FairwayKSActive
DSH170040BKChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Rad Therapy LS4881 NE Goodview CircleLee's SummitMOActive
DSH170040BLChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc LS4881 NE Goodview CircleLee's SummitMOActive
DSH170040BMChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment LS4881 NE Goodview CircleLee's SummitMOActive
DSH170040BNChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Laboratory LS4881 NE Goodview CircleLee's SummitMOActive
DSH170040BPChildDSHUNIVERSITY OF KANSAS HOSPITALCV Heart Rhythm Mgmt State Ave5701 State Ave.Kansas CityKSActive
DSH170040BQChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV State Ave5701 State Ave.Kansas CityKSActive
DSH170040BRChildDSHUNIVERSITY OF KANSAS HOSPITALCV Nuclear State Ave5701 State Ave.Kansas CityKSActive
DSH170040BSChildDSHUNIVERSITY OF KANSAS HOSPITALLaboratory KUMW7405 RENNER RDShawneeKSActive
DSH170040BTChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc KUMW7405 RENNER RDShawneeKSActive
DSH170040BUChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc North8700 N. Green Hills RoadKansas CityMOActive
DSH170040BVChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Laboratory North8700 N. Green Hills RoadKansas CityMOActive
DSH170040BWChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Rad Therapy North8700 N. Green Hills RoadKansas CityMOActive
DSH170040BXChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment North8700 N. Green Hills RoadKansas CityMOActive
DSH170040BYChildDSHKANSAS UNIVERSITY HOSPITALUNIV OF KANSAS CANCER CENTER WEST - KUCC WEST-CLIN TRT8919 PARALLEL PKWY 326KANSAS CITYKSTerminated
DSH170040BZChildDSHKANSAS UNIVERSITY HOSPITALUNIV OF KANSAS CANCER CENTER WEST - KUCC WEST-LAB8919 PARALLEL PKWY 326KANSAS CITYKSTerminated
DSH170040CChildDSHKANSAS UNIVERSITY HOSPITALKUCC WEST-EXAM8919 Parallel ParkwayKansas CityKSTerminated
DSH170040CAChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc AHSOne Arrowhead DriveKansas CityMOActive
DSH170040CBChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc ICC10710 Nall Ave.Overland ParkKSActive
DSH170040CCChildDSHUNIVERSITY OF KANSAS HOSPITALIP Phlebotomy Main Campus2000 Olathe BlvdKansas CityKSActive
DSH170040CDChildDSHUNIVERSITY OF KANSAS HOSPITALMEDICAL PAVILION - MOB RADIOLOGY-SPORTS MED2000 Olathe BlvdKansas CityKSActive
DSH170040CEChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc MP2000 Olathe BlvdKansas CityKSActive
DSH170040CFChildDSHUNIVERSITY OF KANSAS HOSPITALSpecialty Clinic2000 Olathe BlvdKansas CityKSActive
DSH170040CGChildDSHUNIVERSITY OF KANSAS HOSPITALCA7 Neurosurgery & Surg Onc3825 Cambridge St.Kansas CityKSActive
DSH170040CHChildDSHUNIVERSITY OF KANSAS HOSPITALCA6 Neuro & ENT Progrsv Cr3825 Cambridge St.Kansas CityKSActive
DSH170040CJChildDSHUNIVERSITY OF KANSAS HOSPITALCA5 ICU3825 Cambridge St.Kansas CityKSActive
DSH170040CKChildDSHUNIVERSITY OF KANSAS HOSPITALPre/Post Operative ICC10710 Nall Ave.Overland ParkKSActive
DSH170040CLChildDSHUNIVERSITY OF KANSAS HOSPITALINDIAN CREEK CAMPUS - SPINE CENTER10730 Nall Ave.Overland ParkKSActive
DSH170040CMChildDSHUNIVERSITY OF KANSAS HOSPITALCA 11 Medical Oncology3825 Cambridge St.Kansas CityKSActive
DSH170040CNChildDSHUNIVERSITY OF KANSAS HOSPITALOperating Room CA3825 Cambridge St.Kansas CityKSActive
DSH170040CPChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam ICC10710 Nall Ave.Overland ParkKSActive
DSH170040CQChildDSHUNIVERSITY OF KANSAS HOSPITALInterventional Radiology CA3825 Cambridge St.Kansas CityKSActive
DSH170040CRChildDSHUNIVERSITY OF KANSAS HOSPITALMEDICAL PAVILION - ADDICTIONS TREATMENT CENTER3901 Rainbow BlvdKansas CityKSActive
DSH170040CSChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc CA3825 Cambridge St.Kansas CityKSActive
DSH170040CTChildDSHUNIVERSITY OF KANSAS HOSPITALPre/Post Operative CA3825 Cambridge St.Kansas CityKSActive
DSH170040CUChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV CA3825 Cambridge St.Kansas CityKSActive
DSH170040CVChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Rad Therapy ICC10730 Nall AveOverland ParkKSActive
DSH170040CWChildDSHUNIVERSITY OF KANSAS HOSPITALLaboratory ICC10710 Nall Ave.Overland ParkKSActive
DSH170040CXChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Pediatric Allergy PV7301 Mission RoadPrairie VillageKSActive
DSH170040CYChildDSHUNIVERSITY OF KANSAS HOSPITALSurgery Bariatric CMP10700 Nall Ave.Overland ParkKSActive
DSH170040CZChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Infusion Center CA3825 Cambridge St.Kansas CityKSActive
DSH170040DAChildDSHUNIVERSITY OF KANSAS HOSPITALENT General CMP10787 Nall Ave.Overland ParkKSActive
DSH170040DBChildDSHUNIVERSITY OF KANSAS HOSPITALSKC Med Pavilion Family Phys1000 E. 101st TerraceKansas CityMOActive
DSH170040DCChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics Behav Health PV7301 Mission RdPRAIRIE VILLAGEKSTerminated
DSH170040DDChildDSHUNIVERSITY OF KANSAS HOSPITALPlastic Surgery ICC10777 Nall Ave.Overland ParkKSActive
DSH170040DEChildDSHUNIVERSITY OF KANSAS HOSPITALPRAIRIE VILLAGE - Ped Gen Clinic7301 Mission RoadPrairie VillageKSActive
DSH170040DFChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics General PV7301 Mission RoadPrairie VillageKSActive
DSH170040DGChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Westwood Int Med2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040DHChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Westwood Urgent Care2650 SHAWNEE MISSION PKWYWESTWOODKSTerminated
DSH170040DJChildDSHUNIVERSITY OF KANSAS HOSPITALComKC KUMW Urgent Care7405 RENNER RDSHAWNEEKSActive
DSH170040DKChildDSHUNIVERSITY OF KANSAS HOSPITALPRAIRIE VILLAGE - Resident Peds Gen Clinic7301 Mission RdPRAIRIE VILLAGEKSTerminated
DSH170040DLChildDSHUNIVERSITY OF KANSAS HOSPITALKUMW Therapy7405 Renner RdSHAWNEEKSActive
DSH170040DMChildDSHUNIVERSITY OF KANSAS HOSPITALComKC KUMW Int Med7405 RENNER RDSHAWNEEKSActive
DSH170040DNChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn PV7301 Mission RoadPrairie VillageKSActive
DSH170040DPChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Med Plaza Int Med10787 Nall Ave.Overland ParkKSActive
DSH170040DQChildDSHUNIVERSITY OF KANSAS HOSPITALComKC KUMW Family Practice7405 RENNER RDSHAWNEEKSActive
DSH170040DRChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics Cardiology PV7301 Mission RoadPrairie VillageKSActive
DSH170040DSChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Creekwood Urgent Care6420 N. Prospect Ave.GladstoneMOActive
DSH170040DTChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Creekwood Family Care6420 N. Prospect Ave.GladstoneMOActive
DSH170040DUChildDSHUNIVERSITY OF KANSAS HOSPITALNORTH KANSAS CITY - NKC Neurosurg Clinic2790 Clay Edwards DrNORTH KANSAS CITYMOTerminated
DSH170040DVChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Grand Blvd FM1403 Grand Blvd.Kansas CityMOActive
DSH170040DWChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Prairie Village Family Med7301 Mission RoadPrairie VillageKSActive
DSH170040DXChildDSHUNIVERSITY OF KANSAS HOSPITALENT General MP2000 Olathe BlvdKansas CityKSActive
DSH170040DYChildDSHUNIVERSITY OF KANSAS HOSPITALUrology General CMP10777 Nall Ave.Overland ParkKSActive
DSH170040DZChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics Multispecialty MP2000 Olathe BlvdKansas CityKSActive
DSH170040EChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam OPK12200 W. 110th StreetOverland ParkKSActive
DSH170040EAChildDSHUNIVERSITY OF KANSAS HOSPITALPsychiatry General CMP10777 Nall Ave.Overland ParkKSActive
DSH170040EBChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn UroGyn MP2000 Olathe BlvdKansas CityKSActive
DSH170040ECChildDSHUNIVERSITY OF KANSAS HOSPITALINDIAN CREEK CAMPUS - ICC INFUSION CLINIC10710 Nall AveOVERLAND PARKKSTerminated
DSH170040EDChildDSHUNIVERSITY OF KANSAS HOSPITALSurgery Pediatric MP2000 Olathe BlvdKansas CityKSActive
DSH170040EEChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Dermatology MP2000 Olathe BlvdKansas CityKSActive
DSH170040EFChildDSHUNIVERSITY OF KANSAS HOSPITALFam Med General MP2000 Olathe BlvdKansas CityKSActive
DSH170040EGChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Clinical Pharm MP2000 Olathe BlvdKansas CityKSActive
DSH170040EHChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Nephrology MP2000 Olathe BlvdKansas CityKSActive
DSH170040EJChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics General MP2000 Olathe BlvdKansas CityKSActive
DSH170040EKChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Allergy MP2000 Olathe BlvdKansas CityKSActive
DSH170040ELChildDSHUNIVERSITY OF KANSAS HOSPITALMEDICAL PAVILION - Osteo Clinic2000 Olathe BlvdKansas CityKSTerminated
DSH170040EMChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Infectious Disease MP2000 Olathe BlvdKansas CityKSActive
DSH170040ENChildDSHUNIVERSITY OF KANSAS HOSPITALPsychiatry Adult MP2000 Olathe BlvdKansas CityKSActive
DSH170040EPChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn MFM MP2000 Olathe BlvdKansas CityKSActive
DSH170040EQChildDSHUNIVERSITY OF KANSAS HOSPITALSurgery Clinic MP2000 Olathe BlvdKansas CityKSActive
DSH170040ERChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn MP2000 Olathe BlvdKansas CityKSActive
DSH170040ESChildDSHUNIVERSITY OF KANSAS HOSPITALUrology General MP2000 Olathe BlvdKansas CityKSActive
DSH170040ETChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Gastro (GI) MP2000 Olathe BlvdKansas CityKSActive
DSH170040EUChildDSHUNIVERSITY OF KANSAS HOSPITALMEDICAL PAVILION - Miller Eye & Optometry Clinic2000 Olathe BlvdKansas CityKSActive
DSH170040EVChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Pulmonary MP2000 Olathe BlvdKansas CityKSActive
DSH170040EWChildDSHUNIVERSITY OF KANSAS HOSPITALMedical Pavilion - OrthoSurg PT MP2000 Olathe BlvdKansas CityKSActive
DSH170040EXChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Endoocrinology MP2000 Olathe BlvdKansas CityKSActive
DSH170040EYChildDSHUNIVERSITY OF KANSAS HOSPITALOrthoSurgery General MP2000 Olathe BlvdKansas CityKSActive
DSH170040EZChildDSHUNIVERSITY OF KANSAS HOSPITALNeuroSurgery Brain Trauma Clin2000 Olathe BlvdKansas CityKSActive
DSH170040FChildDSHUNIVERSITY OF KANSAS HOSPITALSKC Med Pavilion Exam1000 E. 101st TerraceKansas CityMOActive
DSH170040FAChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Gen Med MP2000 Olathe BlvdKansas CityKSActive
DSH170040FBChildDSHUNIVERSITY OF KANSAS HOSPITALPlastic Surgery MP2000 Olathe BlvdKansas CityKSActive
DSH170040FCChildDSHUNIVERSITY OF KANSAS HOSPITALNeuroSurgery General MP2000 Olathe BlvdKansas CityKSActive
DSH170040FDChildDSHUNIVERSITY OF KANSAS HOSPITALRehab Medicine MP2000 Olathe BlvdKansas CityKSTerminated
DSH170040FEChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Rheumatology BH2000 Olathe BlvdKansas CityKSActive
DSH170040FFChildDSHUNIVERSITY OF KANSAS HOSPITALOphth State Line7400 State Line RoadPrairie VillageKSActive
DSH170040FGChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics General KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040FHChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Gastro (GI) KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040FJChildDSHUNIVERSITY OF KANSAS HOSPITALAnest Pain Mgmt KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040FKChildDSHUNIVERSITY OF KANSAS HOSPITALRehab Medicine KUMW7405 RENNER RDSHAWNEEKSTerminated
DSH170040FLChildDSHUNIVERSITY OF KANSAS HOSPITALPsychiatry General QV12000 W. 110th St.Overland ParkKSActive
DSH170040FMChildDSHUNIVERSITY OF KANSAS HOSPITALCV Clinic Switzer7420 Switzer RdShawneeKSActive
DSH170040FNChildDSHUNIVERSITY OF KANSAS HOSPITALINDIAN CREEK CAMPUS - ICC SPINE/SPORTS MED RADIOLOGY10730 Nall AveOVERLAND PARKKSActive
DSH170040FPChildDSHUNIVERSITY OF KANSAS HOSPITALCV Heart Rhythm Mgmt Switzer7420 Switzer RdShawneeKSActive
DSH170040FQChildDSHUNIVERSITY OF KANSAS HOSPITALFam Med ArrowheadOne Arrowhead DriveKansas CityMOActive
DSH170040FRChildDSHUNIVERSITY OF KANSAS HOSPITALUrology General KUMW7405 RENNER RDSHAWNEEKSTerminated
DSH170040FSChildDSHUNIVERSITY OF KANSAS HOSPITALBMT Treatment WW2650 Shawnee Mission Pkwy.WestwoodKSActive
DSH170040FTChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn QV12000 W. 110th St.Overland ParkKSActive
DSH170040FUChildDSHUNIVERSITY OF KANSAS HOSPITALINDIAN CREEK CAMPUS - CV ICC-CLINIC10710 NALL AVEOVERLAND PARKKSTerminated
DSH170040FVChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Dermatology KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040FWChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn UroGyn QV12000 W. 110th St.Overland ParkKSActive
DSH170040FXChildDSHUNIVERSITY OF KANSAS HOSPITALLaboratory Quivira Spec Clinic12000 W. 110th St.Overland ParkKSActive
DSH170040FYChildDSHUNIVERSITY OF KANSAS HOSPITALINDIAN CREEK CAMPUS - CV ICC-HEART RHYTHM MGMT10710 NALL AVEOVERLAND PARKKSTerminated
DSH170040FZChildDSHUNIVERSITY OF KANSAS HOSPITALOrtho Surgery General KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040GChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam LS4881 NE Goodview CircleLee's SummitMOActive
DSH170040GAChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV Switzer7420 Switzer RdShawneeKSActive
DSH170040GBChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Pulmonary KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040GCChildDSHUNIVERSITY OF KANSAS HOSPITALENT Cosmetic & Plastics KUMW7405 RENNER RDSHAWNEEKSActive
DSH170040GDChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Endocrine Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GEChildDSHUNIVERSITY OF KANSAS HOSPITALObGyn MFM QV12000 W. 110th St.Overland ParkKSActive
DSH170040GFChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Hematology Exam MP2000 Olathe BlvdKansas CityKSActive
DSH170040GGChildDSHUNIVERSITY OF KANSAS HOSPITALQuivira Medical Pavilion - Int Med Dermatology Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GHChildDSHUNIVERSITY OF KANSAS HOSPITALQuivira Medical Pavilion - Int Med Pulmonary Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GJChildDSHUNIVERSITY OF KANSAS HOSPITALCorporate Medical Plaza - CMP Radiology10787 Nall Ave.Overland ParkKSActive
DSH170040GKChildDSHUNIVERSITY OF KANSAS HOSPITALUKH ComKC MP Urgent Care2000 Olathe BlvdKansas CityKSActive
DSH170040GLChildDSHUNIVERSITY OF KANSAS HOSPITALQuivira Medical Pavilion - Int Med Diabetes Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GMChildDSHUNIVERSITY OF KANSAS HOSPITALQuivira Medical Pavilion - Int Med Nephrology Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GNChildDSHUNIVERSITY OF KANSAS HOSPITALQuivira Medical Pavilion - Int Med Gastroenterology Clinic QV12000 W. 110th St.Overland ParkKSActive
DSH170040GPChildDSHUNIVERSITY OF KANSAS HOSPITALGrand Blvd - Grand Blvd Radiology1403 Grand Blvd.Kansas CityMOActive
DSH170040GQChildDSHUNIVERSITY OF KANSAS HOSPITALCambridge Tower A - CA9 Hematology & BMT3825 Cambridge St.Kansas CityKSActive
DSH170040GRChildDSHUNIVERSITY OF KANSAS HOSPITALMedical Pavilion - Pulmonary Function Lab2000 Olathe BlvdKansas CityKSActive
DSH170040GSChildDSHUNIVERSITY OF KANSAS HOSPITALCambridge Tower A - CA Lab3825 Cambridge St.Kansas CityKSActive
DSH170040GTChildDSHUNIVERSITY OF KANSAS HOSPITALCambridge Tower A - CA 10 BMT/Cellular Therapies3825 Cambridge St.Kansas CityKSActive
DSH170040GUChildDSHUNIVERSITY OF KANSAS HOSPITALMarillac - Pediatrics Behav Health Marillac8000 W. 127th St.Overland ParkKSActive
DSH170040GVChildDSHUNIVERSITY OF KANSAS HOSPITALMedical Pavilion - Interventional Radiology MP2000 Olathe BlvdKansas CityKSActive
DSH170040GWChildDSHUNIVERSITY OF KANSAS HOSPITALIndian Creek Campus - CV Echo/PV Vascular Surgery10700 Nall AveOverland ParkKSActive
DSH170040GXChildDSHUNIVERSITY OF KANSAS HOSPITALIndian Creek Campus - Surgery VSA Vein10700 Nall AveOverland ParkKSActive
DSH170040GYChildDSHUNIVERSITY OF KANSAS HOSPITALIndian Creek Campus - Fam Med ICC10700 Nall AveOverland ParkKSActive
DSH170040GZChildDSHUNIVERSITY OF KANSAS HOSPITALIndian Creek Campus - Surgery VSA Ultrasound10700 Nall AveOverland ParkKSActive
DSH170040HChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam North8700 N. Green Hills RoadKansas CityMOActive
DSH170040HAChildDSHUNIVERSITY OF KANSAS HOSPITALIndian Creek Campus - Surgery VSA Vascular10700 Nall AveOverland ParkKSActive
DSH170040HBChildDSHUNIVERSITY OF KANSAS HOSPITALMarillac - Psychiatry Child Marillac8000 W. 127th St.Overland ParkKSActive
DSH170040HCChildDSHUNIVERSITY OF KANSAS HOSPITALCambridge Tower A - CA8 ICU Med/Surg3825 Cambridge St.Kansas CityKSActive
DSH170040HDChildDSHUNIVERSITY OF KANSAS HOSPITALCambridge Tower A - CA8 Heme3825 Cambridge St.Kansas CityKSActive
DSH170040HEChildDSHUNIVERSITY OF KANSAS HOSPITALCV Echo/PV BH - CVM MPB5 ECHOPV2000 Olathe BlvdKansas CityKSActive
DSH170040HFChildDSHUNIVERSITY OF KANSAS HOSPITALPediatrics Behav Health MP - Peds Behav Health Clinic2000 Olathe BlvdKansas CityKSActive
DSH170040HGChildDSHUNIVERSITY OF KANSAS HOSPITALCV HEART RHYTHM MGMT BH - CV Heart Rhythm2000 Olathe BlvdKansas CityKSActive
DSH170040HHChildDSHUNIVERSITY OF KANSAS HOSPITALInternal Medicine Gen Med ICC- 1st Floor - ICC Internal Medicine 1st floor10700 Nall AveOverland ParkKSActive
DSH170040HJChildDSHUNIVERSITY OF KANSAS HOSPITALComKC Grand Blvd Urgent Care - Grand Blvd Urgent Care Clinic1403 Grand BlvdKansas CityMOActive
DSH170040HKChildDSHUNIVERSITY OF KANSAS HOSPITALClinical Lab Cytogenetics - Cytogenetics Lab11300 Corporate AveLenexaKSActive
DSH170040HLChildDSHUNIVERSITY OF KANSAS HOSPITALCardiovascular Clinic Bell Hospital - CVM MPB5 Clinic2000 Olathe BlvdKansas CityKSActive
DSH170040HNChildDSHUNIVERSITY OF KANSAS HOSPITALLaboratory CPK - Lab Corbin Park6501 W. 135th StOverland ParkKSActive
DSH170040HPChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Gen Med Corbin Park - Int Med Corbin Park6501 W. 135th StOverland ParkKSActive
DSH170040HQChildDSHUNIVERSITY OF KANSAS HOSPITALSouth Clinic Therapies PT/OT - PT/OT Corbin Park6501 W. 135th St.Overland ParkKSActive
DSH170040HRChildDSHUNIVERSITY OF KANSAS HOSPITALCTS Clinic - CTS Clinic2000 Olathe BlvdKansas CityKSActive
DSH170040HSChildDSHUNIVERSITY OF KANSAS HOSPITALLab Cancer Center Olathe - CC OCG Lab15123 OMC PkwyOlatheKSActive
DSH170040HTChildDSHUNIVERSITY OF KANSAS HOSPITALCC OCG CLN TRT - Cancer Treatment Olathe15123 S OMC PKWYOLATHEKSActive
DSH170040HUChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam NKC - Briarcliff Cancer Exam4150 N Mulberry DriveKansas CityMOActive
DSH170040HVChildDSHUNIVERSITY OF KANSAS HOSPITALQCA MAMMO - QCA Mammography12000 W 151ST STOLATHEKSActive
DSH170040HWChildDSHUNIVERSITY OF KANSAS HOSPITALQCA ORTHO CLINIC - QCA Ortho Cl12000 W 151ST STOLATHEKSActive
DSH170040HXChildDSHUNIVERSITY OF KANSAS HOSPITALLab Int Med Olathe - OCB2 Lab20805 W 151st StOlatheKSActive
DSH170040HYChildDSHUNIVERSITY OF KANSAS HOSPITALRVF IM DERMATOLOGY CL - RVF IM Dermatology Clinic10740 Nall AveOverland ParkKSActive
DSH170040HZChildDSHUNIVERSITY OF KANSAS HOSPITALOCB2 IM CL - OCB2 IM Cl (Int Med Amb Comm Olathe)20805 W 151ST STREETOLATHEKSActive
DSH170040JChildDSHUNIVERSITY OF KANSAS HOSPITALCV Clinic OPK10787 Nall Ave.Overland ParkKSActive
DSH170040JAChildDSHUNIVERSITY OF KANSAS HOSPITALCC OCG RAD THER - Cancer Rad Therapy Olathe15123 OMC PKWYOLATHEKSActive
DSH170040JBChildDSHUNIVERSITY OF KANSAS HOSPITALInt Med Gen Med SKC - KCMO South Gen Med Cl1000 E. 101st TerraceKansas CityMOActive
DSH170040JCChildDSHUNIVERSITY OF KANSAS HOSPITALOCA2 IM RHEUM CL - OCA2 IM Rheum Cl20375 W 151ST STOLATHEKSActive
DSH170040JDChildDSHUNIVERSITY OF KANSAS HOSPITALOCA3 IM GASTRO CL - OCA3 IM Gastro CL (Int Med Gastro Comm Olathe)20375 W 151ST STOLATHEKSActive
DSH170040JEChildDSHUNIVERSITY OF KANSAS HOSPITALQCA Sono - QCA Sonography12000 W. 151st StOlatheKSActive
DSH170040JFChildDSHUNIVERSITY OF KANSAS HOSPITALOCA2 NEUROLOGY CL - Neurology Clinic Olathe20375 W 151ST STOLATHEKSActive
DSH170040JGChildDSHUNIVERSITY OF KANSAS HOSPITALLab Olathe Medical Pavilion A - OCA4 Lab- Olathe20375 W 151st StOlatheKSActive
DSH170040JHChildDSHUNIVERSITY OF KANSAS HOSPITALQCA UROLOGY CL - QCA Urology Cl (Urology QC)12000 W 151ST STOLATHEKSActive
DSH170040JJChildDSHUNIVERSITY OF KANSAS HOSPITALCenter for Advanced Disease - MPB4 CCM Gastro IBD2000 Olathe BlvdKansas CityKSToBeTerminated
DSH170040JKChildDSHUNIVERSITY OF KANSAS HOSPITALOCA2 IM PULMONARY CL - OCA2 IM Pulm Cl (Int Med Pulm Comm Olathe)20375 W 151ST STOLATHEKSActive
DSH170040JLChildDSHUNIVERSITY OF KANSAS HOSPITALOrthosurgery PT ICC - ICD2 PT Sports Med10730 Nall AveOverland ParkKSActive
DSH170040JMChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology General QC - QCA Gen Radiology12000 W. 151st StOlatheKSActive
DSH170040JNChildDSHUNIVERSITY OF KANSAS HOSPITALQCA CT - QCA CT12000 W 151ST STOLATHEKSActive
DSH170040JPChildDSHUNIVERSITY OF KANSAS HOSPITALQCA MRI - QCA MRI12000 W 151ST STOLATHEKSActive
DSH170040JQChildDSHUNIVERSITY OF KANSAS HOSPITALOCA INFUSION CL - OCA2 Infusion Clinic20375 W 151ST STOLATHEKSActive
DSH170040JRChildDSHUNIVERSITY OF KANSAS HOSPITALPsychiatry Adult MP-ICC - ICC Sports Psych10730 Nall AveOverland ParkKSActive
DSH170040JSChildDSHUNIVERSITY OF KANSAS HOSPITALQCA PLASTIC SURGERY CL - QCA Plastic Surgery Cl (Plastic Surgery QC)12000 W 151ST STOLATHEKSActive
DSH170040JTChildDSHUNIVERSITY OF KANSAS HOSPITALOCB2 IM ENDO CL - OCB2 IM Endo Cl (Int Med Endocrinology Comm Olathe)20805 W 151ST STOLATHEKSActive
DSH170040JUChildDSHUNIVERSITY OF KANSAS HOSPITALOrthosurgery Hand Therapy ICC - OCD2 Hand Therapy10730 Nall AveOverland ParkKSActive
DSH170040JVChildDSHUNIVERSITY OF KANSAS HOSPITALQCA LAB - Laboratory QC12000 W 151ST STOLATHEKSActive
DSH170040JWChildDSHUNIVERSITY OF KANSAS HOSPITALCC OCG EXM - Cancer Exam Olathe15123 OMC PKWYOLATHEKSActive
DSH170040JXChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Treatment NKC - Briarcliff Treatment Area4150 N Mulberry DriveKansas CityMOActive
DSH170040KChildDSHUNIVERSITY OF KANSAS HOSPITALCV Clinic Liberty1530 N. Church RoadLibertyMOActive
DSH170040LChildDSHUNIVERSITY OF KANSAS HOSPITALCV Clinic State Ave5701 State Ave.Kansas CityKSActive
DSH170040MChildDSHUNIVERSITY OF KANSAS HOSPITALCardiac Rehab OPK10787 Nall Ave.Overland ParkKSActive
DSH170040NChildDSHUNIVERSITY OF KANSAS HOSPITALRadiology Multidisc W Plaza1901 W. 47th PlaceWestwoodKSActive
DSH170040PChildDSHUNIVERSITY OF KANSAS HOSPITALOrtho & Sports Medicine ICC10730 Nall Ave.Overland ParkKSActive
DSH170040QChildDSHUNIVERSITY OF KANSAS HOSPITALCC CRC EXAM/PROC RM4350 Shawnee Mission Pkwy.FairwayKSActive
DSH170040RChildDSHUNIVERSITY OF KANSAS HOSPITALLandon Center3599 Rainbow Blvd.Kansas CityKSActive
DSH170040SChildDSHUNIVERSITY OF KANSAS HOSPITALSleep Disorders Center4720 Rainbow Blvd.WestwoodKSActive
DSH170040TChildDSHUNIVERSITY OF KANSAS HOSPITALICC IP NURSING UNIT10710 Nall Ave.Overland ParkKSActive
DSH170040UChildDSHKANSAS UNIVERSITY HOSPITALMid-America Cardiology/Kansas City5501 NW 62ND TERRKANSAS CITYMOTerminated
DSH170040VChildDSHUNIVERSITY OF KANSAS HOSPITALNeurology ICC10777 Nall Ave.Overland ParkKSActive
DSH170040WChildDSHUNIVERSITY OF KANSAS HOSPITALCancer Exam NKC2750 Clay Edwards DriveNorth Kansas CityMOTerminated
DSH170040XChildDSHUNIVERSITY OF KANSAS HOSPITALCV Clinic LVN3601 S. 4th St.LeavenworthKSActive
DSH170040YChildDSHUNIVERSITY OF KANSAS HOSPITALSports Med Clinic ArrowheadOne Arrowhead DriveKansas CityMOActive
DSH170040ZChildDSHUNIVERSITY OF KANSAS HOSPITALOP Surgery State Line7400 State Line RoadPrairie VillageKSActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertChange Request Olathe Health Cancer Center Pharmacy 15123 S. OMC Parkway Olathe, KS 6606111/13/2024 10:11 AM
AddressesShipping AddressInsertChange Request TUKHS-Olathe Infusion Pharmacy 20375 W 151st S Suite 208 Olathe, KS 6606111/13/2024 10:11 AM
AddressesShipping AddressDeleteRecertificationUniversity of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1333 Kansas City, KS 66103 9/6/2024 12:39 PM
AddressesShipping AddressDeleteRecertificationUniversity of Kansas Hospital Cancer 2330 Shawnee Mission Pkwy Westwood, KS 66205 9/6/2024 12:39 PM
AddressesShipping AddressDeleteRecertificationUniversity of Kansas Hospital-Southlake Shared 11300 Corporate Ave 170 Lenexa, KS 66219 9/6/2024 12:39 PM
AddressesShipping AddressDeleteRecertificationUniversity of Kansas Hospital Westwood Infusion 2330 SHAWNEE MISSION PKWY 3301 WESTWOOD, KS 66205 9/6/2024 12:39 PM
AddressesShipping AddressDeleteRecertificationUniversity of Kansas Hospital - Strawberry Hill 901 N. 5th Street Kansas City, KS 66101 9/6/2024 12:39 PM
AddressesShipping AddressDeleteRecertificationThe University of Kansas Health System Indian Creek Retail Pharmacy 10710 Nall Ave 1301 Overland Park, KS 66211 9/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Cambridge Retail Pharmacy 3825 Cambridge Street Suite 1333 Kansas City, KS 661039/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Cancer Center Pharmacy 2330 Shawnee Mission Pkwy Westwood, KS 662059/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital-Southlake Shared Services 11300 Corporate Ave Suite 170 Lenexa, KS 662199/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Westwood Infusion 2330 SHAWNEE MISSION PKWY Suite 3301 WESTWOOD, KS 662059/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification TUKHS-Strawberry Hill Campus Hospital 901 N. 5th Street Kansas City, KS 661019/6/2024 12:39 PM
AddressesShipping AddressInsertRecertification The University of Kansas Health System Indian Creek Retail Pharmacy 10710 Nall Ave Suite 1301 Overland Park, KS 662119/6/2024 12:39 PM
DetailsLast Recertification DateUpdateRecertification8/30/2023 4:15:37 PM9/6/2024 12:39:25 PM9/6/2024 12:39 PM
AddressesShipping AddressUpdateChange RequestUniversity of Kansas Hospital - Main Receiving 2015 WEST 39TH STREET KANSAS CITY, KS 66103The University of Kansas Health System Bell- (Inpatient) 2015 WEST 39TH STREET B421 KANSAS CITY, KS 6610310/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestUniversity of Kansas Hospital Southlake 11300 Corporate Avenue Suite 160 Lenexa, KS 66219University of Kansas Hospital Home Infusion 11300 Corporate Avenue Suite 160 Lenexa, KS 6621910/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestUniversity of Kansas Hospital Southlake 11300 Corporate Avenue Suite 120 Lenexa, KS 66219University of Kansas Hospital Southlake Retail 11300 Corporate Avenue Suite 120 Lenexa, KS 6621910/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestUniversity of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1370 Kansas City, KS 66103The University of Kansas-Cambridge Inpatient 3825 Cambridge Street Suite 1370 Kansas City, KS 6610310/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestKUCC OP-PHARMACY 12200 W 110th Street Overland Park, KS 66210Kansas City Cancer Center SW University of Kansas 12200 W 110th Street Overland Park, KS 6621010/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestCC-PHARMACY 2330 Shawnee Mission Pkwy Westwood, KS 66205University of Kansas Hospital Cancer 2330 Shawnee Mission Pkwy Westwood, KS 6620510/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestKUCC LS-PHARMACY 4881 NE GOODVIEW CIR LEES SUMMIT, MO 64064University of Kansas Hospital Authority Cancer Center Pharmacy East 4881 NE GOODVIEW CIR LEES SUMMIT, MO 6406410/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestUniversity of KS Hospital Indian Creek Campus Pharmacy 10710 Nall Ave Overland Park, KS 66211The University of Kansas Health System Indian Creek- (Inpatient Pharmacy) 10710 Nall Ave 1302 Overland Park, KS 6621110/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestKUCC SOUTH-PHARMACY 1000 E 101st TERRACE Kansas City, MO 64131University of Kansas Hospital Authority Cancer Center Pharmacy South 1000 E 101st TERRACE Kansas City, MO 6413110/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestKUCC NORTH-PHARMACY 8700 N Green Hills Rd Kansas City, MO 64154University of Kansas Hospital Authority Cancer Center Pharmacy North 8700 N Green Hills Rd Kansas City, MO 6415410/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestSOUTHLAKE WAREHOUSE 11300 Corporate Ave 170 Lenexa, KS 66219University of Kansas Hospital-Southlake Shared 11300 Corporate Ave 170 Lenexa, KS 6621910/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestSouthlake Warehouse 11300 Corporate Ave 180 Lenexa, KS 66219University of KS Hospital Southlake Warehouse 11300 Corporate Ave 180 Lenexa, KS 6621910/23/2023 1:20 PM
AddressesShipping AddressUpdateChange RequestKUCC WW-PHARMACY 2330 SHAWNEE MISSION PKWY 3301 WESTWOOD, KS 66205University of Kansas Hospital Westwood Infusion 2330 SHAWNEE MISSION PKWY 3301 WESTWOOD, KS 6620510/23/2023 1:20 PM
AddressesShipping AddressInsertChange Request The University of Kansas Health System Bell Hospital Tower (Retail Pharmacy) 2015 W. 39th Ave G401 Kansas City, KS 6610310/23/2023 1:20 PM
AddressesShipping AddressInsertChange Request The University of Kansas Health System Indian Creek Retail Pharmacy 10710 Nall Ave 1301 Overland Park, KS 6621110/23/2023 1:20 PM
ContactsPrimary ContactUpdatePC Change RequestLubeck, Monica Marie VP Financial Operations University of Kansas Health System 9135886632Holt, Todd Pharmacy Operations Manager The University of Kansas Hospital 91394582919/27/2023 10:39 AM
DetailsLast Recertification DateUpdateRecertification9/1/2022 4:17:10 PM8/30/2023 4:15:37 PM8/30/2023 4:15 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100103330G (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100103330K (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100099470A (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100103330U (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100103330B (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100103330A (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100319330D (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100319330B (KS) 10/3/2022 4:11 PM
Medicaid BillingMedicaid: NumberDeleteGroup Change Request100099470W (KS) 10/3/2022 4:11 PM
DetailsLast Recertification DateUpdateRecertification9/7/2021 12:35:00 PM9/1/2022 4:17:10 PM9/1/2022 4:17 PM
Medicaid BillingMedicaid: NumberDeleteChange Request30003938300004 (KS) 7/7/2022 4:15 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/7/2022 4:15 PM
Medicaid BillingMedicaid: NumberInsertChange Request 100103330A7/7/2022 4:15 PM
Medicaid BillingMedicaid: StateInsertChange Request KS7/7/2022 4:15 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/7/2022 4:15 PM
Medicaid BillingMedicaid: NumberInsertChange Request 100319330D7/7/2022 4:15 PM
Medicaid BillingMedicaid: StateInsertChange Request KS7/7/2022 4:15 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039358300054/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039358300104/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039358300094/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039358300494/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039358300034/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False4/8/2022 9:39 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 300039383000044/8/2022 9:39 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request KS4/8/2022 9:39 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/11/2022 10:23 AM
Medicaid BillingMedicaid: NumberInsertChange Request 300039358300351/11/2022 10:23 AM
Medicaid BillingMedicaid: StateInsertChange Request KS1/11/2022 10:23 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/11/2022 10:23 AM
Medicaid BillingMedicaid: NumberInsertChange Request 300039358300301/11/2022 10:23 AM
Medicaid BillingMedicaid: StateInsertChange Request KS1/11/2022 10:23 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/11/2022 10:23 AM
Medicaid BillingMedicaid: NumberInsertChange Request 300039358300391/11/2022 10:23 AM
Medicaid BillingMedicaid: StateInsertChange Request KS1/11/2022 10:23 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/11/2022 10:23 AM
Medicaid BillingMedicaid: NumberInsertChange Request 300039358300041/11/2022 10:23 AM
Medicaid BillingMedicaid: StateInsertChange Request KS1/11/2022 10:23 AM
DetailsLast Recertification DateUpdateRecertification8/25/2020 9:14:50 AM9/7/2021 12:35:00 PM9/7/2021 12:35 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/25/2020 9:14 AM
Medicaid BillingMedicaid: NumberInsertRecertification 6000740468/25/2020 9:14 AM
Medicaid BillingMedicaid: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/25/2020 9:14 AM
Medicaid BillingMedicaid: NumberInsertRecertification 6000740478/25/2020 9:14 AM
Medicaid BillingMedicaid: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/25/2020 9:14 AM
Medicaid BillingMedicaid: NumberInsertRecertification 100103330B8/25/2020 9:14 AM
Medicaid BillingMedicaid: StateInsertRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 10637958968/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 10930036758/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 12659215068/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 14172451928/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 14573350368/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 15387268808/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 16492596568/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 17003958788/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: NumberInsertRecertification 19629116938/25/2020 9:14 AM
Medicaid BillingNPI: StateInsertRecertification MO8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
Medicaid BillingNPI: StateUpdateRecertification KS8/25/2020 9:14 AM
DetailsLast Recertification DateUpdateRecertification8/19/2019 2:12:09 PM8/25/2020 9:14:50 AM8/25/2020 9:14 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False4/10/2020 9:01 AM
Medicaid BillingMedicaid: NumberInsertChange Request 100103330U4/10/2020 9:01 AM
Medicaid BillingMedicaid: StateInsertChange Request KS4/10/2020 9:01 AM
DetailsEntity NameUpdateChange RequestKANSAS UNIVERSITY HOSPITALUNIVERSITY OF KANSAS HOSPITAL4/1/2020 5:10 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/19/2019 2:12 PM
Medicaid BillingMedicaid: NumberInsertRecertification 6000729858/19/2019 2:12 PM
Medicaid BillingMedicaid: StateInsertRecertification MO8/19/2019 2:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/19/2019 2:12 PM
Medicaid BillingMedicaid: NumberInsertRecertification 6000728428/19/2019 2:12 PM
Medicaid BillingMedicaid: StateInsertRecertification MO8/19/2019 2:12 PM
Medicaid BillingNPI: NumberInsertRecertification 15387268808/19/2019 2:12 PM
DetailsLast Recertification DateUpdateRecertification8/31/2018 10:36:20 AM8/19/2019 2:12:09 PM8/19/2019 2:12 PM
AddressesShipping AddressInsertChange Request Clinical Research Center 4350 Shawnee Mission Parkway 2119 Fairway, KS 662057/3/2019 11:27 AM
AddressesShipping AddressInsertChange Request University of Kansas Hospital - Strawberry Hill 901 N. 5th Street Kansas City, KS 661017/3/2019 11:27 AM
AddressesShipping AddressInsertChange Request KUCC WW-PHARMACY 2330 SHAWNEE MISSION PKWY 3301 WESTWOOD, KS 662052/25/2019 10:42 AM
AddressesShipping AddressInsertChange Request Southlake Warehouse 11300 Corporate Ave 180 Lenexa, KS 662191/8/2019 9:34 AM
AddressesShipping AddressInsertChange Request Safecor 4060 Business Park Drive Columbus, OH 432041/8/2019 9:34 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/8/2019 9:34 AM
Medicaid BillingMedicaid: NumberInsertChange Request 100103330K1/8/2019 9:34 AM
Medicaid BillingMedicaid: StateInsertChange Request KS1/8/2019 9:34 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False10/12/2018 1:06 PM
Medicaid BillingMedicaid: NumberInsertChange Request 100103330G10/12/2018 1:06 PM
Medicaid BillingMedicaid: StateInsertChange Request KS10/12/2018 1:06 PM
DetailsLast Recertification DateUpdateRecertification11/29/2017 7:25:56 PM8/31/2018 10:36:20 AM8/31/2018 10:36 AM
ContactsAuthorizing OfficialUpdateAO Change RequestPETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER University of Kansas Health System 9135881270Couldry, Rick Vice-President, Pharmacy and Clinical Professions University of Kansas Health System 91358823018/27/2018 11:59 AM
ContactsPrimary ContactUpdateChange RequestCouldry, Rick Vice-President, Pharmacy and Clinical Professions University of Kansas Health System 9135882301Lubeck, Monica Marie VP Financial Operations University of Kansas Health System 91358866328/14/2018 12:11 PM
AddressesShipping AddressInsertChange Request KUCC SOUTH-PHARMACY 1000 E 101st TERRACE Kansas City, MO 641317/6/2018 8:07 AM
AddressesShipping AddressInsertChange Request KUCC NORTH-PHARMACY 8700 N Green Hills Rd Kansas City, MO 641547/6/2018 8:07 AM
AddressesShipping AddressInsertChange Request SOUTHLAKE WAREHOUSE 11300 Corporate Ave 170 Lenexa, KS 662197/6/2018 8:07 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/6/2018 8:07 AM
Medicaid BillingMedicaid: NumberInsertChange Request 6000498877/6/2018 8:07 AM
Medicaid BillingMedicaid: StateInsertChange Request MO7/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 14573350367/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 10930036757/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 14172451927/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 10637958967/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 17003958787/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 19629116937/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 12659215067/6/2018 8:07 AM
Medicaid BillingNPI: NumberInsertChange Request 16492596567/6/2018 8:07 AM
AddressesShipping AddressInsertChange Request University of KS Hospital Indian Creek Campus Pharmacy 10710 Nall Ave Overland Park, KS 662115/30/2018 9:59 AM
AddressesShipping AddressInsertChange Request KUCC OP-PHARMACY 12200 W 110th Street Overland Park, KS 662101/9/2018 4:26 PM
AddressesShipping AddressInsertChange Request CC-PHARMACY 2330 Shawnee Mission Pkwy Westwood, KS 662051/9/2018 4:26 PM
AddressesShipping AddressInsertChange Request KUCC LS-PHARMACY 4881 NE GOODVIEW CIR LEES SUMMIT, MO 640641/9/2018 4:26 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/9/2018 4:26 PM
Medicaid BillingMedicaid: NumberInsertChange Request 6060937061/9/2018 4:26 PM
Medicaid BillingMedicaid: StateInsertChange Request MO1/9/2018 4:26 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/9/2018 4:26 PM
Medicaid BillingMedicaid: NumberInsertChange Request 100099470W1/9/2018 4:26 PM
Medicaid BillingMedicaid: StateInsertChange Request KS1/9/2018 4:26 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False1/9/2018 4:26 PM
Medicaid BillingMedicaid: NumberInsertChange Request 6000101631/9/2018 4:26 PM
Medicaid BillingMedicaid: StateInsertChange Request MO1/9/2018 4:26 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Southlake 11300 Corporate Avenue Suite 160 Lenexa, KS 6621911/29/2017 7:25 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1333 Kansas City, KS 6610311/29/2017 7:25 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Southlake 11300 Corporate Avenue Suite 120 Lenexa, KS 6621911/29/2017 7:25 PM
AddressesShipping AddressInsertRecertification University of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1370 Kansas City, KS 6610311/29/2017 7:25 PM
AddressesMain AddressUpdateRecertification 3901 RAINBOW BOULEVARD KANSAS CITY, KS 66160 4000 Cambridge Street Kansas City, KS 6616011/29/2017 7:25 PM
DetailsLast Recertification DateUpdateRecertification8/30/2016 12:00:00 AM11/29/2017 7:25:56 PM11/29/2017 7:25 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestPETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER University of Kansas Hospital 9135881270PETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER University of Kansas Health System 913588127010/10/2017 4:40 PM
ContactsPrimary ContactUpdateProfile Change RequestCouldry, Rick Executive Director of Pharmacy University of Kansas Health System 9135882330Couldry, Rick Vice-President, Pharmacy and Clinical Professions University of Kansas Health System 913588230110/10/2017 2:22 PM
AddressesShipping AddressDeleteChange RequestUniversity of Kansas Hospital Southlake 11300 Corporate Aveneue Suites 120 & 160 Lenexa, KS 66219 10/10/2017 10:29 AM
AddressesShipping AddressDeleteChange RequestUniversity of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1333 & 1370 Kansas City, KS 66103 10/10/2017 10:29 AM
AddressesShipping AddressInsertChange Request University of Kansas Hospital - Main Receiving 2015 WEST 39TH STREET KANSAS CITY, KS 6610310/10/2017 10:29 AM
AddressesShipping AddressInsertChange Request University of Kansas Hospital Southlake 11300 Corporate Aveneue Suites 120 & 160 Lenexa, KS 6621910/10/2017 10:29 AM
AddressesShipping AddressInsertChange Request University of Kansas Hospital Cambridge Tower A 3825 Cambridge Street Suite 1333 & 1370 Kansas City, KS 6610310/10/2017 10:29 AM
ContactsAuthorizing OfficialUpdate PETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER 9135881270PETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER University of Kansas Hospital 91358812709/26/2017 2:13 PM
ContactsPrimary ContactUpdate Couldry, Rick Executive Director of Pharmacy 9135882330Couldry, Rick Executive Director of Pharmacy University of Kansas Health System 91358823309/18/2017 4:48 PM
ContactsAuthorizing OfficialInsert  PETERMAN, TAMMY EXECUTIVE VP, COO, CHIEF NURSING OFFICER 91358812708/11/2017 11:04 AM
ContactsPrimary ContactInsert  Couldry, Rick Executive Director of Pharmacy 91358823305/24/2017 1:43 PM
AddressesShipping AddressDelete THE UNIVERSITY OF KANSAS HOSPITAL RECEIVING DOCK 2015 WEST 39TH STREET KANSAS CITY, KS 66160 5/24/2017 1:43 PM
AddressesMain AddressInsert   3901 RAINBOW BOULEVARD KANSAS CITY, KS 661605/24/2017 1:43 PM
AddressesShipping AddressInsert  THE UNIVERSITY OF KANSAS HOSPITAL RECEIVING DOCK 2015 WEST 39TH STREET KANSAS CITY, KS 661605/24/2017 1:43 PM
DetailsLast Recertification DateUpdate 8/19/2015 12:00:00 AM8/30/2016 12:00:00 AM8/30/2016 12:31 PM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse8/19/2015 12:50 PM
DetailsLast Recertification DateUpdate 8/28/2014 12:00:00 AM8/19/2015 12:00:00 AM8/19/2015 12:50 PM
DetailsLast Recertification DateUpdate 9/5/2013 12:00:00 AM8/28/2014 12:00:00 AM8/28/2014 8:05 AM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM9/5/2013 12:00:00 AM9/5/2013 6:27 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/4/2012 10:07 AM
Medicaid BillingMedicaid: NumberInsert  100099470A6/4/2012 10:07 AM
Medicaid BillingMedicaid: StateInsert  KS6/4/2012 10:07 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False6/4/2012 10:07 AM
Medicaid BillingMedicaid: NumberInsert  0105678086/4/2012 10:07 AM
Medicaid BillingMedicaid: StateInsert  MO6/4/2012 10:07 AM
DetailsEntity SubnameUpdate OUTPATIENT PHARMACY 6/4/2012 10:07 AM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/26/2012 1:34 PM
DetailsLast Recertification DateInsert   1/21/2010 3:37 PM
DetailsGrant NumberInsert   1/21/2010 3:37 PM
Details340B IDInsert  DSH1700401/21/2010 3:37 PM
DetailsIs Authorizing Official EHB DataInsert   1/21/2010 3:37 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/21/2010 3:37 PM
DetailsMedicare Provider NumberInsert  1700401/21/2010 3:37 PM
DetailsEntity NameInsert  KANSAS UNIVERSITY HOSPITAL1/21/2010 3:37 PM
DetailsProgram CodeInsert  DSH1/21/2010 3:37 PM
DetailsEntity SubnameInsert  OUTPATIENT PHARMACY1/21/2010 3:37 PM
DatesParticipating Approval DateInsert  9/7/2007 12:00:00 AM1/21/2010 3:37 PM
DetailsStateInsert  Active1/21/2010 3:37 PM
DatesRegistration DateInsert  9/7/2007 12:00:00 AM1/21/2010 3:37 PM
DatesSigned By DateInsert  8/21/2007 12:00:00 AM1/21/2010 3:37 PM
DatesStart DateInsert  10/1/2000 12:00:00 AM1/21/2010 3:37 PM
TerminationsTermination CommentsInsert   1/21/2010 3:37 PM
TerminationsTermination DateInsert   1/21/2010 3:37 PM
TerminationsTermination Effective DateInsert   1/21/2010 3:37 PM
TerminationsTermination ReasonInsert   1/21/2010 3:37 PM
DetailsComments PublicInsert  12/8/04 UPDATED MEDICAID #(WAS 6086212101)1/21/2010 3:37 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False9/7/2007 3:05 PM
Medicaid BillingMedicaid: NumberInsert  6005678049/7/2007 3:05 PM
Medicaid BillingMedicaid: StateInsert  MO9/7/2007 3:05 PM
Medicaid BillingMedicaid: Is PrimaryInsert  True9/7/2007 3:05 PM
Medicaid BillingMedicaid: NumberInsert  100319330B9/7/2007 3:05 PM
Medicaid BillingMedicaid: StateInsert  KS9/7/2007 3:05 PM