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PED263302-32 The Children's Mercy Hospital (Terminated)
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Main Details
Name
The Children's Mercy Hospital
Subdivision Name
East Campus Cariology Clinic
Type
Children's Hospital
Rural
No
340B ID
PED263302-32
Medicare Provider Number
263302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/13/2014
Last Recertification Date
8/17/2015
Termination Date
Termination Reason
1/1/2016
Site closure
Contacts
Authorizing Official
Children's Mercy Hospitals and Clinics
Cheri Hunt, Senior Vice President for Patient Care Services Chief Nursing Officer
(816) 234-3728
Primary Contact
Children's Mercy Hospital
Brian O'Neal, Senior VP of Allied Health
(816) 302-8059
Addresses
Street Address
2401 Gillham Road
Kansas City, MO 64108
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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