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SCH260034-03 BATES COUNTY MEMORIAL HOSPITAL (Approved)
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Main Details
Name
BATES COUNTY MEMORIAL HOSPITAL
Subdivision Name
BATES COUNTY MEMORIAL HOSPITAL - Family Care Clinic Nursery Street
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH260034-03
Medicare Provider Number
260034
Outpatient Facility Provider Number
268606
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/5/2025
Last Recertification Date
Contacts
Authorizing Official
Bates County Memorial Hospital
Greg Weaver, CEO
(660) 200-7105
Primary Contact
Bates County Memorial Hospital
Jennifer Wainscott, Director of Finance
(660) 200-7002
Addresses
Street Address
617 W NURSERY ST
BUTLER, MO 64730-1840
Billing Address
Bates County Memoiral Hospital
615 W. Nursery St
P.O. box 370
Butler, MO 64730
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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The information entered for the Total Cost and Outpatient Charges for Line 88.00 are incorrect. Please update the information and submit the registration again. Hospitals registering outpatient facilities are asked to enter several figures from Worksheet A and Worksheet C from the latest filed Medicare cot report as well as a trial balance. Total costs from the cost center/line associated with the site being registered are found on Worksheet A, column 7. ($4,133,597) Outpatient charges associated with the cost center line being registered are found on Worksheet C, column 7. ($3,922,233) If the costs and charges from more than one clinic, service or facility are rolled up to a single cost center, you will need the specific costs and charges from the working trial balance. Please return this registration by 5/7/25. If you are unable to act on this record for any reason, please provide an explanation in the review box and return it to OPA. Records returned without action will be rejected. Thank you.
05/02/2025
May 2025
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