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DSH260141DQ University of Missouri Health Care (Active)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
EMERGENCY DEPARTMENT JC - Emergency Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141DQ
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
3/6/2025
Last Recertification Date
Contacts
Authorizing Official
University of Missouri Health Care
KERI SIMON, Chief Operating Officer, Hospital Services
(573) 882-8359
Primary Contact
University of Missouri Health Care
Jacob Simons, Pharmacy Business Director
(573) 884-4614
Addresses
Street Address
1125 MADISON ST
JEFFERSON CITY, MO 65101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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