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CH07137H SOUTHEAST MISSOURI HEALTH NETWORK (Active)
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Main Details
Name
SOUTHEAST MISSOURI HEALTH NETWORK
Subdivision Name
Otto Bean Medical Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010945
340B ID
CH07137H
Grant Number
H80CS00557
Additional Details
Current Program Status
Active
Registration Date
1/1/2005
Participating Start Date
1/1/2005
Participating Approval Date
11/9/2004
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
SEMO Health Network
CHRIS JONES, CEO
(573) 313-2501
Primary Contact
Southeast Missouri Health Network
Mallory Matthews, Chief Clinical Officer
(573) 313-2500
Addresses
Street Address
500 Russell Street
Kennett, MO 63857
Billing Address
SOUTHEAST MISSOURI HEALTH NETWORK, INC
6738 St. Hwy. 77
Benton, MO 63736
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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5/5/09 ADDR & NAME CHANGE (WAS KENNETT MIGRANT/FAMILY CLINIC @ 807 SOUTH BYPASS) NEW SITE 01/01/2005
05/05/2009
April 2025
April 2025
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