340B Drug Pricing Program Database


SCH260097-00 WESTERN MISSOURI MEDICAL CENTER (Active) - information as of 6/26/2025 12:24:24 AM

Main Details
WESTERN MISSOURI MEDICAL CENTER
Sole Community Hospital
Yes
SCH260097-00
260097


Additional Details
Active
7/24/2015
10/1/2015
8/11/2015
8/16/2024

Contacts

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

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

Addresses

403 BURKARTH ROAD
WARRENSBURG, MO 64093

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
8/11/15 CE reinstated effective 10/1/15, was participating from 7/1/13 to 6/30/15; not participating from 7/1/15 to 9/30/15 due to DSH% below statutory minimum08/11/2015
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
MO540421203,0104212041083601330,1548926322,1477128817
Shipping Addresses

Same as Street Address
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
MEMPHISTN38134-884901/16/201704/01/2017 10/07/201910/08/2019
Contract DetailACCREDO HEALTH GROUP INC201 GREAT CIRCLE ROAD
NASHVILLETN3722801/16/201704/01/2017 04/01/201712/14/2018
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/16/201704/01/2017 10/07/201910/08/2019
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/05/201807/01/2018 07/01/201812/14/2018
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624101/16/201704/01/2017 10/07/201910/08/2019
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282201/16/201704/01/2017 04/01/201712/14/2018
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/16/201704/01/2017 04/01/201712/14/2018
Contract DetailAUBURN PHARMACY, INC.AUBURN PHARMACY #265 1200 E 10TH ST STE B
HOLDENMO64040-880012/07/201701/01/2018 01/01/201812/14/2018
Contract DetailAUBURN PHARMACY, INC.AUBURN PHARMACY #265 1200 E 10TH ST STE B
HOLDENMO64040-880004/03/202007/01/2020  07/01/2020
Contract DetailAUBURN PHARMACY, INC.AUBURN PHARMACY #270 810 W 35TH ST STE 101
HIGGINSVILLEMO6403707/01/202010/01/2020  10/01/2020
Contract DetailBRITT'S CENTRAL DRUG STORE728 S MAIN ST P.O. BOX 630
CONCORDIAMO6402007/01/202010/01/2020  10/01/2020
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/19/202104/01/2021  04/01/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/19/202104/01/2021  04/01/2021
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870604/02/202107/01/2021  07/01/2021
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/02/202107/01/2021  07/01/2021
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/19/202104/01/2021  04/01/2021
Contract DetailHY-VEE, INC.4707 FLEUR DR.
DES MOINESIA5032107/02/202110/01/2021 03/29/202203/29/2022
Contract DetailHY-VEE, INC.HY-VEE PHARMACY #1845 410 E. YOUNG AVE
WARRENSBURGMO6409307/02/202110/01/2021 03/29/202203/29/2022
Contract DetailMERRYFIELD PHARMACY INC200 W BENTON ST.
WINDSORMO6536004/13/202007/01/2020 09/21/202009/21/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10305 100 EAST BROADWAY BLVD
SEDALIAMO6530110/08/201901/01/2020  01/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS PHARMACY #11313 101 S 2ND ST
ODESSAMO6407610/08/201901/01/2020  01/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #11312 1030 MAIN STREET
LEXINGTONMO6406710/08/201901/01/2020  01/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #11307 610 BURKARTH RD.
WARRENSBURGMO6409310/08/201901/01/2020  01/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #11310 320 E LEXINGTON ST
RICHMONDMO6408510/08/201901/01/2020  01/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY #11316 941 CHEROKEE DR STE 1
MARSHALLMO6534004/10/202007/01/2020  07/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05691 11115 E US HWY 24 HWY
INDEPENDENCEMO6405404/10/202007/01/2020  07/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10152 1501 E. OHIO ST.
CLINTONMO6473504/10/202007/01/2020  07/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05661 409 E NORTH AVE
BELTONMO6401204/10/202007/01/2020  07/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08590 315 W 75TH STREET
KANSAS CITYMO6411404/10/202007/01/2020  07/01/2020
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10241 1315 WEST 23RD ST.
INDEPENDENCEMO6405004/10/202007/01/2020 02/01/202202/03/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08557 1900 N.E. LANGSFORD RD.
LEES SUMMITMO6406301/19/202104/01/2021 02/01/202202/03/2022
Contract DetailMISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08557 1900 N.E. LANGSFORD RD.
LEES SUMMITMO6406304/18/202307/01/2023  07/01/2023
Contract DetailOMNICARE OF KANSAS CITYOMINCARE PHARMACY OF THE MIDWEST LLC 10400 HICKMAN MILLS DR, SUITE 200
KANSAS CITYMO6413707/02/202110/01/2021  10/01/2021
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/10/202007/01/2020  07/01/2020
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/19/202104/01/2021  04/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/19/202104/01/2021  04/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/19/202104/01/2021  04/01/2021
Contract DetailRED CROSS PHARMACY610 BURKARTH ROAD
WARRENSBURGMO6409307/12/201310/01/2013 07/01/201508/01/2017
Contract DetailRED CROSS PHARMACY610 BURKARTH ROAD
WARRENSBURGMO6409304/12/201607/01/2016 06/15/201806/20/2018
Contract DetailSUMMERS PHARMACY OF WARRENSBURG, LLC611 BURKARTH RD
WARRENSBURGMO64093-146110/08/201901/01/2020  01/01/2020
Contract DetailSWEET SPRINGS PHARMACY INC401 S LOCUST ST
SWEET SPRINGSMO6535107/01/202010/01/2020 02/01/202202/03/2022
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738607/11/201810/01/2018  10/01/2018
Contract DetailWAL-MART PHARMACY 10-0061301 E COOPER AVE
WARRENSBURGMO6409304/15/201407/01/2014 07/01/201508/01/2017
Contract DetailWAL-MART PHARMACY 10-0061301 E COOPER AVE
WARRENSBURGMO6409301/15/201604/01/2016  08/01/2017
Contract DetailWAL-MART PHARMACY 10-02193201 W BROADWAY
SEDALIAMO6530110/08/201901/01/2020 02/01/202202/03/2022
Contract DetailWAL-MART PHARMACY 10-02193201 W BROADWAY
SEDALIAMO6530110/04/202401/01/2025  01/01/2025
Contract DetailWAL-MART PHARMACY 10-03261180 W 19TH STREET
HIGGINSVILLEMO6403710/08/201901/01/2020  01/01/2020
Contract DetailWAL-MART PHARMACY 10-2856201 SO. SALEM STREET
OAK GROVEMO6407510/08/201901/01/2020 09/21/202009/21/2020
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283707/11/201810/01/2018  10/01/2018
Contract DetailWALGREEN CODBA: WALGREENS #11925 400 S. BROADWAY
OAK GROVEMO6407510/08/201901/01/2020  01/01/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 01235 621 N MAGUIRE ST
WARRENSBURGMO64093-141910/16/201301/01/2014 07/01/201508/01/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 01235 621 N MAGUIRE ST
WARRENSBURGMO64093-141901/15/201604/01/2016  08/01/2017
Contract DetailWALGREEN CO.DBA: WALGREENS # 07428 801 S LIMIT
SEDALIAMO65301-524810/08/201901/01/2020  01/01/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 04204 401 NE BARRY ROAD
KANSAS CITYMO6415510/08/201901/01/2020  01/01/2020
Contract DetailWALGREEN CO.DBA: WALGREENS # 09382 412 PAWNEE STREET
CLINTONMO64735-248110/08/201901/01/2020  01/01/2020
Contract DetailWalgreens Central Fill #213942601 Hughes Road
Suite 103 		LibertyMO6406807/14/202310/01/2023  10/01/2023
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/16/201301/01/2014 07/01/201508/01/2017
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/14/201610/01/2016 12/31/201703/12/2020
Contract DetailWALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528410/04/201701/01/2018  10/04/2017
Contract DetailWALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528610/04/201701/01/2018  10/04/2017
Contract DetailWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275604/06/202307/01/2023  07/01/2023
Contract DetailWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616810/04/202401/01/2025  01/01/2025
Contract DetailWESTERN MISSOURI MEDICAL CTR403 BURKARTH RD
WARRENSBURGMO64093-310101/08/201604/01/2016 03/06/201903/06/2019
Contract DetailWOODS PHARMACY #24891047 S. MAGUIRE
WARRENSBURGMO6409307/12/201310/01/2013 07/01/201508/01/2017
Contract DetailWOODS PHARMACY #24891047 S. MAGUIRE
WARRENSBURGMO6409301/10/201604/01/2016 01/10/202001/13/2020
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
SCH260097-01ChildSCHWestern Missouri Medical CenterWestern Missouri Specialty Services427-B Burkarth RoadWarrensburgMOTerminated
SCH260097-02ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC VI - KNOB NOSTER600 E. AllenKnob NosterMOActive
SCH260097-03ChildSCHWESTERN MISSOURI MEDICAL CENTERWestern Missouri Family Healthcare807 W. 2nd StreetHoldenMOTerminated
SCH260097-04ChildSCHWestern Missouri Medical CenterWestern Missouri Women's Health Center415-A Burkarth RoadWarrensburgMOTerminated
SCH260097-05ChildSCHWESTERN MISSOURI MEDICAL CENTERWestern Missouri Cardiology427-A Burkarth RoadWarrensburgMOTerminated
SCH260097-06ChildSCHWESTERN MISSOURI MEDICAL CENTERINTERNAL MEDICINE514 Burkarth RoadWarrensburgMOTerminated
SCH260097-07ChildSCHWESTERN MISSOURI MEDICAL CENTERSURGICAL SERVICES407 Burkarth RdWarrensburgMOActive
SCH260097-08ChildSCHWESTERN MISSOURI MEDICAL CENTERWESTERN MO BONE & JOINT407 Burkarth RdWarrensburgMOActive
SCH260097-09ChildSCHWESTERN MISSOURI MEDICAL CENTERAMBC403 BurkarthWarrensburgMOTerminated
SCH260097-10ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC IV - EXPRESS CARE427 Burkarth RdWarrensburgMOActive
SCH260097-11ChildSCHWESTERN MISSOURI MEDICAL CENTERSLEEP STUDY407 Burkarth RdWarrensburgMOActive
SCH260097-12ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC - WOMENS HEALTH415 A Burkarth RdWarrensburgMOActive
SCH260097-13ChildSCHWESTERN MISSOURI MEDICAL CENTERWMMC - Emergency403 Burkarth RdWarrensburgMOTerminated
SCH260097-14ChildSCHWESTERN MISSOURI MEDICAL CENTERWMMC - Infusion CTR407 Burkarth RdWarrensburgMOTerminated
SCH260097-15ChildSCHWESTERN MISSOURI MEDICAL CENTERWMMC - Wound Center403 Burkarth RdWarrensburgMOTerminated
SCH260097-16ChildSCHWESTERN MISSOURI MEDICAL CENTERPAIN CENTER407 Burkarth RdWarrensburgMOActive
SCH260097-17ChildSCHWESTERN MISSOURI MEDICAL CENTERWARRENSBURG INTERNAL MEDICINE511 BURKARTH ROADWARRENSBURGMOActive
SCH260097-18ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC III - HIGGINSVILLE1200 West 22ndHigginsvilleMOActive
SCH260097-19ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC II - WARRENSBURG513 Burkarth RoadWarrensburgMOActive
SCH260097-20ChildSCHWESTERN MISSOURI MEDICAL CENTEREAR NOSE THROAT CLINIC407 BURKARTH RD STE 302WARRENSBURGMOActive
SCH260097-21ChildSCHWESTERN MISSOURI MEDICAL CENTERSPECIALTY CLINIC (RHEUMATOLOGY & NEPH)407 BURKARTH RD STE 302WARRENSBURGMOActive
SCH260097-22ChildSCHWESTERN MISSOURI MEDICAL CENTERWestern MO Specialty Services - Nephrology407 BURKARTH RD STE 302WARRENSBURGMOTerminated
SCH260097-23ChildSCHWESTERN MISSOURI MEDICAL CENTERNeurology / .427 BURKARTH ROADWARRENSBURGMOTerminated
SCH260097-24ChildSCHWESTERN MISSOURI MEDICAL CENTERPULMONOLOGY407 Burkarth RdWARRENSBURGMOActive
SCH260097-25ChildSCHWESTERN MISSOURI MEDICAL CENTERBUILDING BLOCKS PEDIATRICS510 Foster LaneWARRENSBURGMOActive
SCH260097-26ChildSCHWESTERN MISSOURI MEDICAL CENTERWestern MO Specialty Services - Vascular - Vascular407 Burkarth RdWARRENSBURGMOTerminated
SCH260097-27ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC V - CFSM407 E RUSSELL AVE BLDG CWARRENSBURGMOActive
SCH260097-28ChildSCHWESTERN MISSOURI MEDICAL CENTERRURAL HEALTH CLINIC VII - CONCORDIA905 S MAIN STCONCORDIAMOActive
SCH260097-29ChildSCHWESTERN MISSOURI MEDICAL CENTERUROLOGY CLINIC - UROLOGY407 BURKARTH RDWARRENSBURGMOActive
SCH260097-30ChildSCHWESTERN MISSOURI MEDICAL CENTERNON INTERVENTIONAL PAIN MEDICINE - NON INTERVENTIONAL PAIN MEDICINE407 BURKARTH RDWARRENSBURGMOTerminated
SCH260097-31ChildSCHWESTERN MISSOURI MEDICAL CENTERWESTERN MISSOURI INTERNAL MEDICINE - INTERNAL MEDICINE502 BURKARTH RDWARRENSBURGMOActive
SCH260097-32ChildSCHWESTERN MISSOURI MEDICAL CENTERHEART CARE OF WARRENSBURG - WARRENSBURG HEART CARE427 BURKARTH RDWARRENSBURGMOActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification8/24/2023 3:10:41 PM8/16/2024 9:52:59 AM8/16/2024 9:52 AM
DetailsLast Recertification DateUpdateRecertification9/8/2022 12:43:28 PM8/24/2023 3:10:41 PM8/24/2023 3:10 PM
Medicaid BillingMedicaid: NumberDeleteChange Request529868 (AZ) 2/15/2023 10:26 AM
Medicaid BillingMedicaid: NumberDeleteChange Request008094255 (CO) 2/15/2023 10:26 AM
Medicaid BillingMedicaid: NumberDeleteChange Request008089600 (CT) 2/15/2023 10:26 AM
Medicaid BillingMedicaid: NumberDeleteChange Request1036840190001 (PA) 2/15/2023 10:26 AM
Medicaid BillingMedicaid: NumberDeleteChange Request11155014 (KS) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (CT) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (AZ) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (CO) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (PA) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1548926322 (CT) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1477128817 (CT) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1548926322 (CO) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1477128817 (CO) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1548926322 (PA) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1477128817 (PA) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1548926322 (AZ) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1477128817 (AZ) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (KS) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1477128817 (KS) 2/15/2023 10:26 AM
Medicaid BillingNPI: NumberDeleteChange Request1548926322 (KS) 2/15/2023 10:26 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False12/6/2022 10:51 AM
Medicaid BillingMedicaid: NumberInsertChange Request 1115501412/6/2022 10:51 AM
Medicaid BillingMedicaid: StateInsertChange Request KS12/6/2022 10:51 AM
Medicaid BillingNPI: NumberInsertChange Request 108360133012/6/2022 10:51 AM
Medicaid BillingNPI: StateInsertChange Request KS12/6/2022 10:51 AM
Medicaid BillingNPI: NumberInsertChange Request 147712881712/6/2022 10:51 AM
Medicaid BillingNPI: StateInsertChange Request KS12/6/2022 10:51 AM
Medicaid BillingNPI: NumberInsertChange Request 154892632212/6/2022 10:51 AM
Medicaid BillingNPI: StateInsertChange Request KS12/6/2022 10:51 AM
Medicaid BillingNPI: NumberInsertRecertification 15489263229/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification MO9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 14771288179/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification MO9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 15489263229/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification CT9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 14771288179/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification CT9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 15489263229/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification CO9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 14771288179/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification CO9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 15489263229/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification PA9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 14771288179/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification PA9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 15489263229/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification AZ9/8/2022 12:43 PM
Medicaid BillingNPI: NumberInsertRecertification 14771288179/8/2022 12:43 PM
Medicaid BillingNPI: StateInsertRecertification AZ9/8/2022 12:43 PM
DetailsLast Recertification DateUpdateRecertification9/15/2021 8:49:33 AM9/8/2022 12:43:28 PM9/8/2022 12:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (CT) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (AZ) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (CO) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (GA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (PA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request540421203 (IA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (CT) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (AZ) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (CO) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (GA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (PA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberDeleteChange Request010421204 (IA) 10/13/2021 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberInsertChange Request 52986810/13/2021 4:43 PM
Medicaid BillingMedicaid: StateInsertChange Request AZ10/13/2021 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberInsertChange Request 00809425510/13/2021 4:43 PM
Medicaid BillingMedicaid: StateInsertChange Request CO10/13/2021 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberInsertChange Request 00808960010/13/2021 4:43 PM
Medicaid BillingMedicaid: StateInsertChange Request CT10/13/2021 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False10/13/2021 4:43 PM
Medicaid BillingMedicaid: NumberInsertChange Request 103684019000110/13/2021 4:43 PM
Medicaid BillingMedicaid: StateInsertChange Request PA10/13/2021 4:43 PM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (GA) 10/13/2021 4:43 PM
Medicaid BillingNPI: NumberDeleteChange Request1083601330 (IA) 10/13/2021 4:43 PM
DetailsLast Recertification DateUpdateRecertification8/18/2020 2:51:07 PM9/15/2021 8:49:33 AM9/15/2021 8:49 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request MO6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request CT6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request AZ6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request CO6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request GA6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request PA6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/8/2021 10:41 AM
Medicaid BillingMedicaid: NumberInsertChange Request 0104212046/8/2021 10:41 AM
Medicaid BillingMedicaid: StateInsertChange Request IA6/8/2021 10:41 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request CT3/30/2021 9:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request AZ3/30/2021 9:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request CO3/30/2021 9:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request GA3/30/2021 9:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request PA3/30/2021 9:43 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/30/2021 9:43 AM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212033/30/2021 9:43 AM
Medicaid BillingMedicaid: StateInsertChange Request IA3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request CT3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request AZ3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request CO3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request GA3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request PA3/30/2021 9:43 AM
Medicaid BillingNPI: NumberInsertChange Request 10836013303/30/2021 9:43 AM
Medicaid BillingNPI: StateInsertChange Request IA3/30/2021 9:43 AM
Medicaid BillingNPI: NumberDeleteRecertification1083601330 ( ) 8/18/2020 2:51 PM
Medicaid BillingNPI: NumberInsertRecertification 10836013308/18/2020 2:51 PM
Medicaid BillingNPI: StateInsertRecertification MO8/18/2020 2:51 PM
DetailsLast Recertification DateUpdateRecertification8/20/2019 10:01:20 AM8/18/2020 2:51:07 PM8/18/2020 2:51 PM
DetailsLast Recertification DateUpdateRecertification9/11/2018 4:13:36 PM8/20/2019 10:01:20 AM8/20/2019 10:01 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/8/2019 3:26 PM
Medicaid BillingMedicaid: NumberInsertChange Request 5404212037/8/2019 3:26 PM
Medicaid BillingMedicaid: StateInsertChange Request MO7/8/2019 3:26 PM
Medicaid BillingNPI: NumberInsertChange Request 10836013307/8/2019 3:26 PM
ContactsPrimary ContactUpdateChange RequestMeyer, Melissa Director of Pharmacy Western Missouri Medical Center 6602627522Chapa, Mary E 340B Coordinator Western Missouri Medical Center 66026272577/8/2019 3:26 PM
ContactsPrimary ContactUpdateRecertificationHughes, Janis Pharmacy Clinical Manager Western Missouri Medical Center 6602627490Meyer, Melissa Director of Pharmacy Western Missouri Medical Center 66026275229/11/2018 4:13 PM
DetailsLast Recertification DateUpdateRecertification11/6/2017 2:24:58 PM9/11/2018 4:13:36 PM9/11/2018 4:13 PM
DetailsLast Recertification DateUpdateRecertification8/20/2016 12:00:00 AM11/6/2017 2:24:58 PM11/6/2017 2:24 PM
ContactsPrimary ContactUpdateChange RequestOhmart, Dean Chief Financial Officer 6602627307Hughes, Janis Pharmacy Clinical Manager Western Missouri Medical Center 66026274909/28/2017 2:19 PM
ContactsAuthorizing OfficialUpdateChange RequestBradley, Terri Chief Financia Officer 6602627307Ohmart, Dean Chief Financial Officer Western Missouri Medical Center 66026273079/28/2017 2:19 PM
AddressesMain AddressInsert   403 BURKARTH ROAD WARRENSBURG, MO 640938/7/2017 3:26 PM
ContactsSigned ByInsert  Gasparini, Michael Chief Operating Officer 66026273038/7/2017 3:26 PM
ContactsAuthorizing OfficialInsert  Bradley, Terri Chief Financia Officer 66026273078/7/2017 3:26 PM
ContactsPrimary ContactInsert  Ohmart, Dean Chief Financial Officer 66026273078/7/2017 3:26 PM
DetailsLast Recertification DateUpdate  8/20/2016 12:00:00 AM8/20/2016 5:35 PM
DetailsLast Recertification DateUpdate 8/20/2014 12:00:00 AM 8/11/2015 2:31 PM
DatesLast Date That 340B Drugs PurchasedUpdate 5/31/2015 12:00:00 AM 8/11/2015 2:31 PM
DetailsEntity NameUpdate Western Missouri Medical CenterWESTERN MISSOURI MEDICAL CENTER8/11/2015 2:31 PM
DatesParticipating Approval DateUpdate 5/14/2013 12:00:00 AM8/11/2015 12:00:00 AM8/11/2015 2:31 PM
DetailsStateUpdate TerminatedActive8/11/2015 2:31 PM
DatesRegistration DateUpdate 4/11/2013 12:00:00 AM7/24/2015 12:00:00 AM8/11/2015 2:31 PM
DatesSigned By DateUpdate 4/11/2013 12:00:00 AM7/24/2015 12:00:00 AM8/11/2015 2:31 PM
DatesStart DateUpdate 7/1/2013 12:00:00 AM10/1/2015 12:00:00 AM8/11/2015 2:31 PM
TerminationsTermination CommentsUpdate This change was unexpected and not representative of our patient mix. We are pursing additional clarification of this data. Upon completion of the analysis we will amend our cost report which will be tentatively available August 2015.  8/11/2015 2:31 PM
TerminationsTermination DateUpdate 7/1/2015 12:00:00 AM 8/11/2015 2:31 PM
TerminationsTermination Effective DateUpdate 6/1/2015 12:00:00 AM 8/11/2015 2:31 PM
TerminationsTermination ReasonUpdate DSH percentage below statutory minimum 8/11/2015 2:31 PM
DetailsComments PublicInsert  8/11/15 CE reinstated effective 10/1/15, was participating from 7/1/13 to 6/30/15; not participating from 7/1/15 to 9/30/15 due to DSH% below statutory minimum8/11/2015 2:31 PM
DatesLast Date That 340B Drugs PurchasedUpdate  5/31/2015 12:00:00 AM6/23/2015 1:37 PM
DetailsStateUpdate ActiveTerminated6/23/2015 1:37 PM
TerminationsTermination CommentsUpdate  This change was unexpected and not representative of our patient mix. We are pursing additional clarification of this data. Upon completion of the analysis we will amend our cost report which will be tentatively available August 2015. 6/23/2015 1:37 PM
TerminationsTermination DateUpdate  7/1/2015 12:00:00 AM6/23/2015 1:37 PM
TerminationsTermination Effective DateUpdate  6/1/2015 12:00:00 AM6/23/2015 1:37 PM
TerminationsTermination ReasonUpdate  DSH percentage below statutory minimum6/23/2015 1:37 PM
DetailsLast Recertification DateUpdate 9/3/2013 12:00:00 AM8/20/2014 12:00:00 AM8/20/2014 2:38 PM
DetailsEntity NameUpdate Western Misssouri Medical CenterWestern Missouri Medical Center9/16/2013 7:24 AM
DetailsLast Recertification DateUpdate  9/3/2013 12:00:00 AM9/3/2013 4:20 PM
Details340B IDUpdate ISDR-SCH260097-00SCH260097-005/14/2013 11:37 AM
DatesParticipating Approval DateUpdate  5/14/2013 12:00:00 AM5/14/2013 11:37 AM
DetailsStateUpdate PendingActive5/14/2013 11:37 AM
DatesStart DateUpdate  7/1/2013 12:00:00 AM5/14/2013 11:37 AM
Details340B IDUpdate ISDR-SCH260097ISDR-SCH260097-005/2/2013 3:35 PM
Details340B IDUpdate DR041113FISDR-SCH2600975/2/2013 3:34 PM
Details340B IDUpdate ONLINE_REGDR041113F4/11/2013 9:18 PM
DetailsLast Recertification DateInsert   4/11/2013 4:13 PM
DetailsGrant NumberInsert   4/11/2013 4:13 PM
Details340B IDInsert  ONLINE_REG4/11/2013 4:13 PM
DetailsIs Authorizing Official EHB DataInsert   4/11/2013 4:13 PM
DatesLast Date That 340B Drugs PurchasedInsert   4/11/2013 4:13 PM
DetailsMedicare Provider NumberInsert  2600974/11/2013 4:13 PM
DetailsEntity NameInsert  Western Misssouri Medical Center4/11/2013 4:13 PM
DetailsProgram CodeInsert  SCH4/11/2013 4:13 PM
DetailsEntity SubnameInsert   4/11/2013 4:13 PM
DatesParticipating Approval DateInsert   4/11/2013 4:13 PM
DetailsStateInsert  Pending4/11/2013 4:13 PM
DatesRegistration DateInsert  4/11/2013 12:00:00 AM4/11/2013 4:13 PM
DatesSigned By DateInsert  4/11/2013 12:00:00 AM4/11/2013 4:13 PM
DatesStart DateInsert   4/11/2013 4:13 PM
TerminationsTermination CommentsInsert   4/11/2013 4:13 PM
TerminationsTermination DateInsert   4/11/2013 4:13 PM
TerminationsTermination Effective DateInsert   4/11/2013 4:13 PM
TerminationsTermination ReasonInsert   4/11/2013 4:13 PM