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SCH260050-00 Mosaic Medical Center Maryville (Terminated)
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Main Details
Name
Mosaic Medical Center Maryville
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH260050-00
Medicare Provider Number
260050
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/19/2013
Last Recertification Date
8/19/2024
Termination Date
Termination Reason
4/1/2025
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Heartland Regional Medical Center
Drew Keesbury, Chief Financial Officer
(816) 271-7070
Primary Contact
Heartland Regional Medical Center
Gayle Linville, Manager Pharmacy Strategic Sourcing
(816) 271-6141
Addresses
Street Address
2016 S. Main
Maryville, MO 64468
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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