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DSH260195AN CITIZENS MEMORIAL HOSPITAL DISTRICT (Active)
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Main Details
Name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Subdivision Name
CMH Health & Wellness Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260195AN
Medicare Provider Number
260195
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/6/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/25/2025
Last Recertification Date
Contacts
Authorizing Official
Citizens Memorial Hospital
Renee Marie Meyer, Chief Financial Officer
(417) 328-6258
Primary Contact
Citizens Memorial Hospital District
Tim Wolters, Director of Reimbursement
(417) 328-7286
Addresses
Street Address
2520 S Springfield Ave
Suite A
Bolivar, MO 65613
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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