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DSH260137AL FREEMAN HEALTH SYSTEM (Active)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
CHILDREN'S CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137AL
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Freeman Health System
Jeff Thompson, Chief Clinical Officer
(417) 347-3563
Primary Contact
Freeman Health System
Greg Cobble, Director of Retail Pharmacy Operations
(417) 347-3078
Addresses
Street Address
1030 MCINTOSH CIR
SUITE 1
JOPLIN, MO 64804-3690
Billing Address
FREEMAN HEALTH SYSTEM
1102 W 32ND ST
JOPLIN, MO 64804
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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