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RWII65201 Spectrum Health Care (Terminated)
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Main Details
Name
Spectrum Health Care
Subdivision Name
Spectrum Health Care
Type
Ryan White Part B
340B ID
RWII65201
Grant Number
X07HA00030-27
Additional Details
Current Program Status
Terminated
Registration Date
1/6/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/12/2014
Last Recertification Date
1/28/2020
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2021
Failure to recertify
Contacts
Authorizing Official
Spectrum Health Care
Cale C Mitchell, Executive Director
(573) 875-8687 Ext: 261
Primary Contact
Spectrum Health Care
Tierney President, Client Services Coordinator
(573) 875-8687
Addresses
Street Address
1123 WIlkes Blvd.
Suite 250
Columbia, MO 65201-4774
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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