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DSH260141P University of Missouri Health Care (Terminated)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
UP- Woodrail Family Medicine Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141P
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/14/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/28/2012
Last Recertification Date
9/2/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
University of Missouri Health Care
Jonathan Curtright, CEO
(573) 884-8738
Primary Contact
University of Missouri Health Care
David Wolfrath, Pharmacy Manager
(573) 882-8700
Addresses
Street Address
1000 W. Nifong
Bldg. 2, Ste.140
Columbia, MO 65203
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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