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DSH260059 Mercy Hospital Lebanon (Active)
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Main Details
Name
Mercy Hospital Lebanon
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260059
Medicare Provider Number
260059
Additional Details
Current Program Status
Active
Registration Date
3/2/2007
Participating Start Date
4/1/2007
Participating Approval Date
3/5/2007
Last Recertification Date
8/20/2024
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
100 HOSPITAL DRIVE
LEBANON, MO 65536-2263
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/28/09 DOC RECD TO CONFIRM ELIG DSH ADJ %
01/21/2010
3/12/12 provided info to change entitiy name from ST. JOHN'S HOSPITAL LEBANON
03/02/2007
April 2025
April 2025
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