Covered Entity Details

DSH260040AY LESTER E COX MEDICAL CENTERS (Active) - information as of 4/25/2025 12:00:36 AM

Main Details

Name

LESTER E COX MEDICAL CENTERS

Subdivision Name

MARTIN CENTER DIAGNOSTIC RADIOLOGY

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260040AY

Medicare Provider Number

260040

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/15/2014

Participating Start Date

4/1/2014

Participating Approval Date

2/28/2014

Last Recertification Date

8/16/2024

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

3901 S FREMONT AVE
SPRINGFIELD, MO 65804

Billing Address

CoxHealth
PO Box 9550
Springfield, MO 65801

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

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

State	Medicaid Number	NPI Number
MO	010419604	1093740128
AR	107962105	1093740128

Shipping Addresses

Shipping Address 1

CoxHealth Pharmacy South
3801 South National Ave
Springfield, MO 65807

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
DSH260040AA	Child	DSH	LESTER E COX MEDICAL CENTERS	Hulston Cancer Center Radiation Center	3850 S National Ave	Springfield	MO	Active
DSH260040AB	Child	DSH	LESTER E COX MEDICAL CENTERS	WORK INJURY REHAB	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040AC	Child	DSH	LESTER E COX MEDICAL CENTERS	ADVANCED PHYSICAL THERAPY	2900-A S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040AD	Child	DSH	LESTER E COX MEDICAL CENTERS	BRANSON THERAPY SERVICES	121 Cahill Road	BRANSON	MO	Terminated
DSH260040AE	Child	DSH	LESTER E COX MEDICAL CENTERS	COXHEALTH URGENT CARE - TURNER	1000 EAST PRIMROSE AVE	SPRINGFIELD	MO	Active
DSH260040AF	Child	DSH	LESTER E COX MEDICAL CENTERS	HYPERBARIC AND WOUND CENTER	3525 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040AJ	Child	DSH	LESTER E COX MEDICAL CENTERS	CENTER FOR HEALTH IMPROVEMENT	3800 South National Avenue	SPRINGFIELD	MO	Active
DSH260040AK	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER ENDOSCOPY	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AL	Child	DSH	LESTER E COX MEDICAL CENTERS DBA COXHEALTH	COXHEALTH SPORTS MEDICINE	3545 S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040AM	Child	DSH	LESTER E COX MEDICAL CENTERS	STEEPLECHASE THERAPY SERVICES	1530 E REPUBLIC RD	SPRINGFIELD	MO	Terminated
DSH260040AN	Child	DSH	LESTER E COX MEDICAL CENTERS	REPUBLIC THERAPY SERVICES	830 S ILLINOIS AVE	REPUBLIC	MO	Terminated
DSH260040AP	Child	DSH	LESTER E COX MEDICAL CENTERS	BONE AND JOINT CENTER THERAPY SERVICES	3555 S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040AQ	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH OUTPATIENT THERAPY	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040AR	Child	DSH	LESTER E COX MEDICAL CENTERS	BREAST CARE CLINIC	3850 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040AS	Child	DSH	LESTER E COX MEDICAL CENTERS	WHEELER ULTRASOUND	3800 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040AT	Child	DSH	LESTER E COX MEDICAL CENTERS	WHEELER NUCLEAR MEDICINE	3800 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040AU	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER ULTRASOUND	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AV	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER COMPUTED TOMOGRAPHY	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AW	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER NUCLEAR MEDICINE PET	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AX	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER IN HOUSE MRI	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AY	Child	DSH	LESTER E COX MEDICAL CENTERS	MARTIN CENTER DIAGNOSTIC RADIOLOGY	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040AZ	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL ULTRASOUND	3535 S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040B	Child	DSH	LESTER E COX MEDICAL CENTERS	WHEELER HEART AND VASCULAR CENTER AMBULATORY INFUSION CENTER	3800 SOUTH NATIONAL AVE.	SPRINGFIELD	MO	Active
DSH260040BA	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL DIAGNOSTIC RADIOLOGY	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040BB	Child	DSH	LESTER E COX MEDICAL CENTERS	LITHOTRIPSY	1000 EAST PRIMROSE AVE	SPRINGFIELD	MO	Active
DSH260040BC	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL PACU	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040BD	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL OPERATING ROOM	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040BE	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL ORTHO CARE UNIT	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040BF	Child	DSH	LESTER E COX MEDICAL CENTERS	SENIOR HEALTH CENTER NORTH	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Terminated
DSH260040BG	Child	DSH	LESTER E COX MEDICAL CENTERS	REGIONAL PERINATOLOGY CLINIC	1000 EAST PRIMROSE AVE #360	SPRINGFIELD	MO	Active
DSH260040BH	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL OP NEURO THERAPY	3535 S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040BJ	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL OP ORTHO THERAPY	3535 S NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040BK	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH ULTRASOUND	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BL	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH COMPUTED TOMOGRAPHY	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BM	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH DIAGNOSTIC RADIOLOGY	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BN	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH OUTPATIENT ORTHO THERAPY	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Terminated
DSH260040BP	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH RESPIRATORY CARE UNIT	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BQ	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH EMERGENCY DEPARTMENT	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BR	Child	DSH	LESTER E COX MEDICAL CENTERS	COX NORTH CENTER FOR ADDICTIONS	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040BS	Child	DSH	LESTER E COX MEDICAL CENTERS	Republic RHC	820 Illinois	Republic	MO	Terminated
DSH260040BT	Child	DSH	LESTER E COX MEDICAL CENTERS	Branson RHC	890 HWY 248	Branson	MO	Terminated
DSH260040BV	Child	DSH	LESTER E COX MEDICAL CENTERS	Senior Health Center South	3525 S National #207	Springfield	MO	Terminated
DSH260040BW	Child	DSH	LESTER E COX MEDICAL CENTERS	CSC SAME DAY / PACU	960 E Walnut Lawn	Springfield	MO	Active
DSH260040BX	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION / SAME DAY SURGERY	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040BY	Child	DSH	LESTER E COX MEDICAL CENTERS	MEDICAL ONCOLOGY	3850 S NATIONAL AVE SUITE 520	SPRINGFIELD	MO	Active
DSH260040BZ	Child	DSH	LESTER E COX MEDICAL CENTERS	WHEELER SLEEP DISORDER CENTER	3800 SOUTH NATIONAL AVE	SPRINGFIELD	MO	Terminated
DSH260040CA	Child	DSH	LESTER E COX MEDICAL CENTERS	COXHEALTH PAIN MANAGEMENT CENTER - CoxHealth Pain Management Center	1001 E PRIMROSE SUITE 2 WEST	SPRINGFIELD	MO	Terminated
DSH260040CB	Child	DSH	LESTER E COX MEDICAL CENTERS	FD GASTROENTEROLOGY - GASTROENTEROLOGY	3901 S FREMONT AVE	SPRINGFIELD	MO	Active
DSH260040CC	Child	DSH	LESTER E COX MEDICAL CENTERS	FD Neurology - Neurology	3801 South National Avenue	Springfield	MO	Active
DSH260040CD	Child	DSH	LESTER E COX MEDICAL CENTERS	RS Neuropsychology Services - Neuropsychology	3801 South National Avenue	Springfield	MO	Terminated
DSH260040CE	Child	DSH	LESTER E COX MEDICAL CENTERS	FD Rheumatology - Rheumatology	3555 South National Avenue	Springfield	MO	Active
DSH260040CF	Child	DSH	LESTER E COX MEDICAL CENTERS	LABORATORY - NORTH LABORATORY SERVICES	1423 N JEFFERSON AVE	SPRINGFIELD	MO	Active
DSH260040CG	Child	DSH	LESTER E COX MEDICAL CENTERS	RESPIRATORY THERAPY - MEYER ORTHOPEDIC & REHABILITATION HOSPITAL RESPIRATORY THERAPY	3535 S NATIONAL AVE	SPRINGFIELD	MO	Active
DSH260040CH	Child	DSH	LESTER E COX MEDICAL CENTERS	CoxHealth Infectious Disease Specialty Clinic - Infectious Disease	3800 South National Avenue #LL99 & #LL110	Springfield	MO	Active
DSH260040CJ	Child	DSH	LESTER E COX MEDICAL CENTERS	CoxHealth Pulmonology - Pulmonology	3800 South National Avenue Ste 510	Springfield	MO	Active
DSH260040CK	Child	DSH	LESTER E COX MEDICAL CENTERS	CoxHealth Cardiovascular Services - Cardiology	3800 South National Ave Ste 400 & Ste 510	Springfield	MO	Active
DSH260040CL	Child	DSH	LESTER E COX MEDICAL CENTERS	CoxHealth Electrophysiology - Electrophysiology	3800 South National Avenue Ste 170	Springfield	MO	Active
DSH260040CM	Child	DSH	LESTER E COX MEDICAL CENTERS	CoxHealth Vascular Surgery & Medicine - Vascular Surgery	3800 South National Avenue Ste 160	Springfield	MO	Active
DSH260040CN	Child	DSH	LESTER E COX MEDICAL CENTERS	Ozarks Dialysis North - Dialysis	1007 E Kearney	Springfield	MO	Active
DSH260040CP	Child	DSH	LESTER E COX MEDICAL CENTERS	COXHEALTH ADVANCED MEDICINE SPECIAL - Diabetes	960 E WALNUT LAWN ST	SPRINGFIELD	MO	Active
DSH260040E	Child	DSH	LESTER E COX MEDICAL CENTERS	HULSTON CANCER CENTER OUTPATIENT ONCOLOGY	3850 SOUTH NATIONAL AVE.	SPRINGFIELD	MO	Active
DSH260040I	Child	DSH	LESTER E COX MEDICAL CENTERS	MEYER ORTHOPEDIC & REHABILITATION HOSPITAL REHAB THERAPY	3535 S. National Ave	SPRINGFIELD	MO	Active
DSH260040K	Child	DSH	LESTER E COX MEDICAL CENTERS	Seymour RHC	202 N. Commercial	Seymour	MO	Active
DSH260040L	Child	DSH	LESTER E COX MEDICAL CENTERS	Marshfield RHC	1245 Banning St	Marshfield	MO	Active
DSH260040M	Child	DSH	LESTER E COX MEDICAL CENTERS	Buffalo RHC	119 N. Ash St.	Buffalo	MO	Active
DSH260040N	Child	DSH	LESTER E COX MEDICAL CENTERS	Crane RHC	102 Courtney Lane	Crane	MO	Terminated
DSH260040O	Child	DSH	LESTER E COX MEDICAL CENTERS	Rogersville RHC	151 Johnstown Drive	Rogersville	MO	Active
DSH260040P	Child	DSH	LESTER E COX MEDICAL CENTERS	Aurora RHC	106 Commerce Dr.	Aurora	MO	Terminated
DSH260040Q	Child	DSH	LESTER E COX MEDICAL CENTERS	Mountain Grove RHC	1602-A N. Main	Mountain Grove	MO	Active
DSH260040R	Child	DSH	LESTER E COX MEDICAL CENTERS	RENAL DIALYSIS I	3525 S. NATIONAL	SPRINGFIELD	MO	Active
DSH260040S	Child	DSH	LESTER E COX MEDICAL CENTERS	RENAL DIALYSIS II	1001 E. PRIMROSE	SPRINGFIELD	MO	Active
DSH260040U	Child	DSH	LESTER E COX MEDICAL CENTERS	RENAL DIALYSIS IV	825 HWY 60	MONETT	MO	Active
DSH260040V	Child	DSH	LESTER E COX MEDICAL CENTERS	COX HEALTH CENTER FOR ADVANCED PAIN MANAGEMENT	3801 S. National Ave	Springfield	MO	Terminated
DSH260040W	Child	DSH	LESTER E COX MEDICAL CENTERS	Mount Vernon RHC	10763 Hwy 39	Mount Vernon	MO	Terminated
DSH260040X	Child	DSH	LESTER E COX MEDICAL CENTERS	Wheeler Heart & Vascular Center Cardiopulmonary Rehabilitation	3800 S National Ave	Springfield	MO	Active
DSH260040Y	Child	DSH	LESTER E COX MEDICAL CENTERS	CSC OPERATING ROOM	960 E Walnut Lawn	Springfield	MO	Active
DSH260040Z	Child	DSH	LESTER E COX MEDICAL CENTERS	JNC Imaging	3801 South National Ave	Springfield	MO	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/14/2023 10:20:11 AM	8/16/2024 5:34:39 PM	8/16/2024 5:34 PM
Details	Last Recertification Date	Update	Recertification	8/25/2022 12:20:45 PM	8/14/2023 10:20:11 AM	8/14/2023 10:20 AM
Contacts	Primary Contact	Update	Change Request	REED, STACIE 340B PROGRAM COORDINATOR CoxHealth 4172696231	Hurst, Michelle 340B Program Coordinator CoxHealth 4177306224	7/3/2023 7:32 AM
Details	Last Recertification Date	Update	Recertification	8/18/2021 12:37:49 PM	8/25/2022 12:20:45 PM	8/25/2022 12:20 PM
Details	Last Recertification Date	Update	Recertification	8/19/2020 11:27:06 AM	8/18/2021 12:37:49 PM	8/18/2021 12:37 PM
Addresses	Billing Address	Update	Recertification	CoxHealth 3801 South National Ave Springfield, MO 65807	CoxHealth PO Box 9550 Springfield, MO 65801	8/19/2020 11:27 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1093740128	8/19/2020 11:27 AM
Medicaid Billing	NPI: State	Insert	Recertification		MO	8/19/2020 11:27 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1093740128	8/19/2020 11:27 AM
Medicaid Billing	NPI: State	Insert	Recertification		AR	8/19/2020 11:27 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1093740128 ( )		8/19/2020 11:27 AM
Details	Last Recertification Date	Update	Recertification	8/20/2019 5:14:09 PM	8/19/2020 11:27:06 AM	8/19/2020 11:27 AM
Details	Last Recertification Date	Update	Recertification	8/16/2018 3:45:21 PM	8/20/2019 5:14:09 PM	8/20/2019 5:14 PM
Details	Last Recertification Date	Update	Recertification	11/6/2017 1:19:39 PM	8/16/2018 3:45:21 PM	8/16/2018 3:45 PM
Addresses	Billing Address	Update	Recertification	CoxHealth Pharmacy South 3801 South National Ave Springfield, MO 65807	CoxHealth 3801 South National Ave Springfield, MO 65807	11/6/2017 1:19 PM
Details	Last Recertification Date	Update	Recertification	8/18/2016 12:00:00 AM	11/6/2017 1:19:39 PM	11/6/2017 1:19 PM
Contacts	Authorizing Official	Update		McWay, Jake SVP - CFO 4172698811	McWay, Jake SVP - CFO CoxHealth 4172698811	9/29/2017 3:49 PM
Contacts	Signed By	Update		McWay, Jake SVP - CFO 4172698811	McWay, Jake SVP - CFO CoxHealth 4172698811	9/29/2017 3:49 PM
Contacts	Primary Contact	Update		REED, STACIE 340B PROGRAM COORDINATOR 4172696231	REED, STACIE 340B PROGRAM COORDINATOR CoxHealth 4172696231	9/19/2017 2:13 PM
Contacts	Primary Contact	Insert			REED, STACIE 340B PROGRAM COORDINATOR 4172696231	8/14/2017 1:22 PM
Contacts	Authorizing Official	Insert			McWay, Jake SVP - CFO 4172698811	8/9/2017 2:52 PM
Contacts	Signed By	Insert			McWay, Jake SVP - CFO 4172698811	8/9/2017 2:52 PM
Details	Last Recertification Date	Update		8/13/2015 12:00:00 AM	8/18/2016 12:00:00 AM	8/18/2016 2:39 PM
Addresses	Main Address	Insert			3901 S FREMONT AVE SPRINGFIELD, MO 65804	8/18/2016 2:39 PM
Addresses	Billing Address	Insert			CoxHealth Pharmacy South 3801 South National Ave Springfield, MO 65807	8/16/2016 1:15 PM
Addresses	Shipping Address	Insert			CoxHealth Pharmacy South 3801 South National Ave Springfield, MO 65807	8/16/2016 1:15 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/21/2016 2:47 PM
Medicaid Billing	Medicaid: Number	Insert			107962105	7/21/2016 2:47 PM
Medicaid Billing	Medicaid: State	Insert			AR	7/21/2016 2:47 PM
Details	Entity Name	Update		LESTER E COX MEDICAL CENTERS DBA COXHEALTH	LESTER E COX MEDICAL CENTERS	9/10/2015 11:13 AM
Details	Last Recertification Date	Update		9/3/2014 12:00:00 AM	8/13/2015 12:00:00 AM	8/13/2015 11:25 AM
Details	Last Recertification Date	Update			9/3/2014 12:00:00 AM	9/3/2014 1:15 PM
Dates	Participating Approval Date	Update			2/28/2014 12:00:00 AM	2/28/2014 5:30 PM
Details	State	Update		Pending	Active	2/28/2014 5:30 PM
Dates	Start Date	Update			4/1/2014 12:00:00 AM	2/28/2014 5:30 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	DSH260040AY	2/25/2014 3:58 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/15/2014 12:15 PM
Medicaid Billing	Medicaid: Number	Insert			010419604	1/15/2014 12:15 PM
Medicaid Billing	Medicaid: State	Insert			MO	1/15/2014 12:15 PM
Medicaid Billing	NPI: Number	Insert			1093740128	1/15/2014 12:15 PM
Details	Last Recertification Date	Insert				1/15/2014 12:15 PM
Details	Grant Number	Insert				1/15/2014 12:15 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	1/15/2014 12:15 PM
Details	Is Authorizing Official EHB Data	Insert				1/15/2014 12:15 PM
Dates	Last Date That 340B Drugs Purchased	Insert				1/15/2014 12:15 PM
Details	Medicare Provider Number	Insert			260040	1/15/2014 12:15 PM
Details	Entity Name	Insert			LESTER E COX MEDICAL CENTERS DBA COXHEALTH	1/15/2014 12:15 PM
Details	Program Code	Insert			DSH	1/15/2014 12:15 PM
Details	Entity Subname	Insert			MARTIN CENTER DIAGNOSTIC RADIOLOGY	1/15/2014 12:15 PM
Dates	Participating Approval Date	Insert				1/15/2014 12:15 PM
Details	State	Insert			Pending	1/15/2014 12:15 PM
Dates	Registration Date	Insert			1/15/2014 12:00:00 AM	1/15/2014 12:15 PM
Dates	Signed By Date	Insert			1/15/2014 12:00:00 AM	1/15/2014 12:15 PM
Dates	Start Date	Insert				1/15/2014 12:15 PM
Terminations	Termination Comments	Insert				1/15/2014 12:15 PM
Terminations	Termination Date	Insert				1/15/2014 12:15 PM
Terminations	Termination Effective Date	Insert				1/15/2014 12:15 PM
Terminations	Termination Reason	Insert				1/15/2014 12:15 PM