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PED263302-01 The Children's Mercy Hospital (Active)
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Main Details
Name
The Children's Mercy Hospital
Subdivision Name
Children's Mercy Clinics on Broadway
Type
Children's Hospital
Rural
No
340B ID
PED263302-01
Medicare Provider Number
263302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/26/2011
Participating Start Date
12/15/2011
Participating Approval Date
12/15/2011
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Children's Mercy Hospital
Brian O'Neal, Senior VP of Allied Health
(816) 302-8059
Primary Contact
Children's Mercy Hospital
Sarah Bledsoe, Senior Director of Pharmacy
(816) 983-6388
Addresses
Street Address
3101 Broadway Street
Kansas City, MO 64111
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/4/12 UPDATED MAIN ADD (WAS 3101 BROADWAY BLVD); 12/15/11 IMMEDIATE START DATE BECAUSE APPROVED DURING A PHE IN MISSOURI
04/04/2012
12/15/11 IMMEDIATE START DATE BECAUSE APPROVED DURING A PHE IN MISSOURI
12/15/2011
May 2025
May 2025
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