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DSH260163 PARKLAND HEALTH CENTER (Active)
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Main Details
Name
PARKLAND HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260163
Medicare Provider Number
260163
Additional Details
Current Program Status
Active
Registration Date
7/2/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/9/2018
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Parkland Health Center
Heather Lynn Taliaferro, Chief Nursing Officer
(573) 760-8239
Primary Contact
Parkland Health Center
Steven ONeal, Procurement Coordinator
(573) 760-8060
Addresses
Street Address
1101 WEST LIBERTY ST
FARMINGTON, MO 63640
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (4/1/2011), until terminated effective date ( 4/1/2012), reinstatement effective date (10/01/2018)
07/09/2018
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