Covered Entity Details

CHC24137-04 Ozarks Resource Group (Active) - information as of 5/1/2025 11:52:12 PM

Main Details

Name

Ozarks Resource Group

Subdivision Name

Ozarks Community Health Center - Miles for Smiles (Mobile)

Type

HRSA-Funded Health Center

Site ID

BPS-H80-027957

340B ID

CHC24137-04

Grant Number

H80CS24137

Additional Details

Current Program Status

Active

Registration Date

10/11/2018

Participating Start Date

1/1/2019

Participating Approval Date

11/15/2018

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

Ozarks Resource Group d/b/a Ozarks Community Health Center
Scott Crouch, CEO
(417) 745-2121

Primary Contact

Ozarks Resource Group d/b/a Ozarks Community Health Center
Lindsay Pearson, CFO
(417) 745-2121

Addresses

Street Address

203 E. Broadway St.
Bolivar, MO 65613-2593

Billing Address

Ozarks Community Health Center
18614 Jackson St.
Hermitage, MO 65668

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	CITIZENS MEMORIAL HEALTH CARE FOUNDATION	STEPHENS PHARMACY AT CMH	1100 S SPRINGFIELD AVE	BOLIVAR	MO	65613-2512	10/13/2023	01/01/2024			01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC24137-00	Active	BPS-H80-011717	Ozarks Resource Group	OCHC - Hermitage Medical Center	18614 Jackson St.	Hermitage	MO
CHC24137-01	Active	BPS-H80-014175	Ozarks Resource Group	OCHC - Hermitage Dental Clinic	18753 Spring St.	Hermitage	MO
CHC24137-02	Active	BPS-H80-033383	OZARKS RESOURCE GROUP	OCHC - Urbana Medical Center	406 S. DALLAS St.	URBANA	MO
CHC24137-03	Active	BPS-H80-027053	OZARKS RESOURCE GROUP	OCHC - Bolivar Dental Clinic	203 E. Broadway St	Bolivar	MO
CHC24137-04	Active	BPS-H80-027957	Ozarks Resource Group	Ozarks Community Health Center - Miles for Smiles (Mobile)	203 E. Broadway St.	Bolivar	MO
CHC24137-05	Terminated	BPS-H80-027788	Ozarks Resource Group	OCHC - Dade Co. Dental Clinic	413 W Water St	Greenfield	MO
CHC24137-06	Active	BPS-H80-034000	OZARKS RESOURCE GROUP	OCHC - Greenfield Dental Clinic	3 N State Highway 39	Greenfield	MO
CHC24137-07	Active	BPS-H80-039363	OZARKS RESOURCE GROUP	OCHC - Stockton Dental Clinic	201 W Smith Dr	Stockton	MO

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC24137-00	ALPS SPECIALTY PHARMACY	105 S RIDGECREST AVE STE 3A		NIXA	MO	65714	01/01/2023
CHC24137-00	CITIZENS MEMORIAL HEALTH CARE FOUNDATION	STEPHENS PHARMACY AT CMH	1100 S SPRINGFIELD AVE	BOLIVAR	MO	65613-2512	06/16/2020	06/16/2020
CHC24137-00	CITIZENS MEMORIAL HEALTH CARE FOUNDATION	STEPHENS PHARMACY AT CMH	1100 S SPRINGFIELD AVE	BOLIVAR	MO	65613-2512	07/01/2021
CHC24137-04	CITIZENS MEMORIAL HEALTH CARE FOUNDATION	STEPHENS PHARMACY AT CMH	1100 S SPRINGFIELD AVE	BOLIVAR	MO	65613-2512	01/01/2024
CHC24137-00	CITIZENS MEMORIAL HOSPITAL	DBA STEPHENS PHARMACY AT CMH	1100 S SPRINGFIELD AVE	BOLIVAR	MO	65613	02/07/2025
CHC24137-00	CITIZENS MEMORIAL HOSPITAL	DBA STEPHENS PHARMACY AT OCHC	406 S DALLAS ST	URBANA	MO	65767	02/14/2025
CHC24137-00	HERMITAGE PROFESS PHARMACY	23649 DALLAS ST	P.O.BOX 370	HERMITAGE	MO	65668	10/01/2013
CHC24137-00	SMITHWAY PHARMACY	SMITHWAY PHARMACY LLC	100 W TILDEN ST	HUMANSVILLE	MO	65674	01/01/2023	05/18/2023
CHC24137-00	STEPHENS PHARMACY	1100 SO SPRINGFIELD		BOLIVAR	MO	65613	10/01/2013	09/30/2019
CHC24137-00	STEPHENS PHARMACY	1100 SO SPRINGFIELD		BOLIVAR	MO	65613	07/01/2021	06/16/2020
CHC24137-00	STEPHENS PHARMACY AT OCHC	406 S DALLAS ST		URBANA	MO	65767	07/19/2022
CHC24137-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CHC24137-00	WAL-MART PHARMACY 10-0046	2451 S SPRINGFIELD		BOLIVAR	MO	65613	04/01/2014
CHC24137-03	WAL-MART PHARMACY 10-0046	2451 S SPRINGFIELD		BOLIVAR	MO	65613	01/01/2024
CHC24137-00	WAL-MART PHARMACY 10-0250	103 W POLK ST		WARSAW	MO	65355	04/01/2014
CHC24137-01	WAL-MART PHARMACY 10-0250	103 W POLK ST		WARSAW	MO	65355	01/01/2024
CHC24137-00	WAL-MART PHARMACY 10-0845	1250 W DALLAS		BUFFALO	MO	65622	07/01/2014
CHC24137-02	WAL-MART PHARMACY 10-0845	1250 W DALLAS		BUFFALO	MO	65622	01/01/2024
CHC24137-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CHC24137-00	WALGREEN CO	DBA: WALGREENS #11666	1820 S SPRINGFIELD AVE	BOLIVAR	MO	65613	10/01/2015
CHC24137-05	WALGREEN CO	DBA: WALGREENS #11666	1820 S SPRINGFIELD AVE	BOLIVAR	MO	65613	01/01/2024	04/01/2024
CHC24137-00	Walgreens Central Fill #21394	2601 Hughes Road	Suite 103	Liberty	MO	64068	04/01/2023
CHC24137-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023
CHC24137-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/5/2024 9:23:20 PM	2/11/2025 9:18:10 PM	2/11/2025 9:18 PM
Details	Last Recertification Date	Update	Recertification	1/30/2023 9:06:19 AM	2/5/2024 9:23:20 PM	2/5/2024 9:23 PM
Details	Entity Subname	Update	Change Request	Ozarks Community Health Center - Miles for Smiles	Ozarks Community Health Center - Miles for Smiles (Mobile)	3/28/2023 8:05 AM
Addresses	Billing Address	Insert	Recertification		Ozarks Community Health Center 18614 Jackson St. Hermitage, MO 65668	1/30/2023 9:06 AM
Details	Last Recertification Date	Update	Recertification	1/31/2022 11:38:25 AM	1/30/2023 9:06:19 AM	1/30/2023 9:06 AM
Details	Last Recertification Date	Update	Recertification	2/3/2021 9:18:24 AM	1/31/2022 11:38:25 AM	1/31/2022 11:38 AM
Details	Last Recertification Date	Update	Recertification	1/27/2020 9:07:47 PM	2/3/2021 9:18:24 AM	2/3/2021 9:18 AM
Contacts	Primary Contact	Update	Profile Change Request	Pearson, Lindsay Financial Accountant Ozarks Resource Group d/b/a Ozarks Community Health Center 4177452121	Pearson, Lindsay CFO Ozarks Resource Group d/b/a Ozarks Community Health Center 4177452121	8/20/2020 11:03 AM
Details	Last Recertification Date	Update	Recertification	1/30/2019 2:23:00 PM	1/27/2020 9:07:47 PM	1/27/2020 9:07 PM
Details	Last Recertification Date	Update	Recertification		1/30/2019 2:23:00 PM	1/30/2019 2:23 PM
Addresses	Main Address	Update	Change Request	800 E. Aldrich Rd., Suite E Bolivar, MO 65613-2593	203 E. Broadway St. Bolivar, MO 65613-2593	1/11/2019 9:22 AM
Details	State	Update		Approved	Active	1/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Crouch, Scott CEO Ozarks Resource Group d/b/a Ozarks Community Health Center 4177452121	11/15/2018 11:26 AM
Details	340B ID	Update	New Registration		CHC24137-04	11/15/2018 11:26 AM
Dates	Participating Approval Date	Update	New Registration		11/15/2018 11:26:45 AM	11/15/2018 11:26 AM
Details	State	Update	New Registration	Pending	Approved	11/15/2018 11:26 AM
Dates	Signed By Date	Update	New Registration		11/9/2018 11:23:31 AM	11/15/2018 11:26 AM
Dates	Start Date	Update	New Registration		1/1/2019 12:00:00 AM	11/15/2018 11:26 AM
Addresses	Main Address	Insert	New Registration		800 E. Aldrich Rd., Suite E Bolivar, MO 65613-2593	10/11/2018 2:24 PM
Contacts	Primary Contact	Insert	New Registration		Pearson, Lindsay Financial Accountant Ozarks Resource Group d/b/a Ozarks Community Health Center 4177452121	10/11/2018 2:24 PM
Contacts	Authorizing Official	Insert	New Registration		Crouch, Scott CEO Ozarks Resource Group d/b/a Ozarks Community Health Center 4177452121	10/11/2018 2:24 PM
Details	Last Recertification Date	Insert	New Registration			10/11/2018 2:24 PM
Details	Grant Number	Insert	New Registration		H80CS24137	10/11/2018 2:24 PM
Details	340B ID	Insert	New Registration			10/11/2018 2:24 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/11/2018 2:24 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/11/2018 2:24 PM
Details	Medicare Provider Number	Insert	New Registration			10/11/2018 2:24 PM
Details	Entity Name	Insert	New Registration		Ozarks Resource Group	10/11/2018 2:24 PM
Details	Program Code	Insert	New Registration		CH	10/11/2018 2:24 PM
Details	Entity Subname	Insert	New Registration		Ozarks Community Health Center - Miles for Smiles	10/11/2018 2:24 PM
Dates	Participating Approval Date	Insert	New Registration			10/11/2018 2:24 PM
Details	State	Insert	New Registration		Pending	10/11/2018 2:24 PM
Dates	Registration Date	Insert	New Registration		10/11/2018 2:24:48 PM	10/11/2018 2:24 PM
Dates	Signed By Date	Insert	New Registration			10/11/2018 2:24 PM
Dates	Start Date	Insert	New Registration			10/11/2018 2:24 PM
Terminations	Termination Comments	Insert	New Registration			10/11/2018 2:24 PM
Terminations	Termination Date	Insert	New Registration			10/11/2018 2:24 PM
Terminations	Termination Effective Date	Insert	New Registration			10/11/2018 2:24 PM
Terminations	Termination Reason	Insert	New Registration			10/11/2018 2:24 PM

340B Drug Pricing Program Database