340B Drug Pricing Program Database
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DSH260009F BOTHWELL REGIONAL HEALTH CENTER (Approved)
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Main Details
Name
BOTHWELL REGIONAL HEALTH CENTER
Subdivision Name
BOTHWELL REGIONAL HTH CENTER - Wound Healing Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260009F
Medicare Provider Number
260009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/14/2025
Last Recertification Date
Contacts
Authorizing Official
Bothwell Regional Health Center
Steven R Davis, Chief Financial Officer
(660) 829-7790
Primary Contact
Bothwell Regional Health Center
Jill Renae Weller, 340B Program Coordinator
(660) 827-9492
Addresses
Street Address
667 E 15TH ST
BOTHWELL WOUND CENTER
SEDALIA, MO 65301-7656
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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