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DSH260040W LESTER E COX MEDICAL CENTERS (Terminated)
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Main Details
Name
LESTER E COX MEDICAL CENTERS
Subdivision Name
Mount Vernon RHC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260040W
Medicare Provider Number
260040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/13/2013
Last Recertification Date
8/13/2015
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
CoxHealth
Jake McWay, SVP - CFO
(417) 269-8811
Primary Contact
CoxHealth
STACIE REED, 340B PROGRAM COORDINATOR
(417) 269-6231
Addresses
Street Address
10763 Hwy 39
Mount Vernon, MO 65712
Billing Address
CoxHealth Pharmacy MORH - Clinics
3801 South National Ave
Springfield, MO 65807
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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