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DSH260065AN MERCY HOSPITAL SPRINGFIELD (Active)
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Main Details
Name
MERCY HOSPITAL SPRINGFIELD
Subdivision Name
Springfield Cancer and Hematology - Hematology and Oncology Mercy CH Chub O Reilly Cancer Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260065AN
Medicare Provider Number
260065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/7/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/4/2025
Last Recertification Date
Contacts
Authorizing Official
Mercy Hospital Springfield
William J Roberts, Vice President Finance
(417) 820-7363
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
2055 S Fremont Ave
2
Springfield, MO 65804-2206
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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