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DSH260141AF University of Missouri Health Care (Terminated)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
WCH Urology & Continence Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141AF
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/15/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/28/2012
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
7/1/2024
Outpatient facility moved within the 4 walls of the parent hospital
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
500 N. Keene Street
Ste. 303
Columbia, MO 65201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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