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DSH260001B Mercy Hospital Joplin (Terminated)
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Main Details
Name
Mercy Hospital Joplin
Subdivision Name
EKG
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260001B
Medicare Provider Number
260001
Outpatient Facility Provider Number
260001
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/15/2014
Last Recertification Date
9/11/2022
Termination Date
Termination Reason
7/1/2023
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Mercy Hospital Joplin
Jonathan T Sturgeon, Vice President-Finance
(417) 556-2459
Primary Contact
Mercy
Mike Loftus, Director-Pharmacy Services
(417) 820-3487
Addresses
Street Address
100 Mercy Way
Joplin, MO 64804
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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