340B Drug Pricing Program Database
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DSH260078AE Ozarks Medical Center DBA Ozarks Healthcare (Active)
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Main Details
Name
Ozarks Medical Center DBA Ozarks Healthcare
Subdivision Name
Ozarks Medical Center DBA Ozarks Healthcare Dermatology - Dermatology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260078AE
Medicare Provider Number
260078
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/1/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
Contacts
Authorizing Official
Ozarks Medical Center DBA Ozarks Healthcare
Lacey Carter, Chief Operating Officer
(417) 256-9111 Ext: 5968
Primary Contact
Ozarks Medical Center DBA Ozarks Healthcare
Katie Mahan, Director of 340B and Specialty Pharmacy Services
(417) 505-7700
Addresses
Street Address
1210 N. Kentucky Ave
West Plains, MO 65775
Billing Address
Ozarks Medical Center DBA Ozarks Healthcare
P.O. Box 1100
West Plains, MO 65775
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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