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DSH260113H MISSOURI DELTA MEDICAL CENTER (Active)
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Main Details
Name
MISSOURI DELTA MEDICAL CENTER
Subdivision Name
Missouri Delta Primary Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260113H
Medicare Provider Number
260113
Outpatient Facility Provider Number
268660
Additional Details
Current Program Status
Active
Registration Date
10/10/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/13/2013
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Missouri Delta Medical Center
JASON SCHRUMPF, CEO
(573) 472-7600
Primary Contact
Missouri Delta Medical Center
Christopher White, Director of Pharmacy
(573) 472-7450
Addresses
Street Address
102 Hospitality Drive
Sikeston, MO 63801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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