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DSH260141CN University of Missouri Health Care (Terminated)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
Cutaneous Micrographic Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141CN
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/11/2014
Last Recertification Date
9/8/2022
Termination Date
Termination Reason
10/1/2023
Other
Contacts
Authorizing Official
University of Missouri Health Care
Katrina Lambrecht, Chief Operating Officer
(573) 882-6467
Primary Contact
University of Missouri Health Care
Jacob Simons, Pharmacy Business Director
(573) 884-4614
Addresses
Street Address
1020 Hitt St.
Columbia, MO 65212-0001
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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