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DSH260141H University of Missouri Health Care (Active)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
UP Callaway Physicians
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141H
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/21/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/28/2012
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
University of Missouri Health Care
KERI SIMON, Chief Operating Officer, Hospital Services
(573) 882-8359
Primary Contact
University of Missouri Health Care
Jacob Simons, Pharmacy Business Director
(573) 884-4614
Addresses
Street Address
110 N. Hospital Drive
Fulton, MO 65251
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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