340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH260195Q CITIZENS MEMORIAL HOSPITAL DISTRICT (Terminated)
Print
Main Details
Name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Subdivision Name
CMH Wound and Hyperbaric Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260195Q
Medicare Provider Number
260195
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/29/2011
Participating Start Date
4/1/2022
Participating Approval Date
12/13/2011
Last Recertification Date
8/15/2023
Termination Date
Termination Reason
7/1/2024
Site closure
Contacts
Authorizing Official
Citizens Memorial Hospital
Renee Marie Meyer, Chief Financial Officer
(417) 328-6258
Primary Contact
Citizens Memorial Hospital District
Tim Wolters, Director of Reimbursement
(417) 328-7286
Addresses
Street Address
1155 West Parkview Street, Suite 1G
Bolivar, MO 65613
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
12/13/11 APPROVED DURING PHE IN MISSOURI
11/29/2011
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session