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DSH260065M MERCY HOSPITAL SPRINGFIELD (Active)
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Main Details
Name
MERCY HOSPITAL SPRINGFIELD
Subdivision Name
MERCY ORTHOPEDIC HOSPITAL SPRINGFIE / Ortho Hospital-Operating Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260065M
Medicare Provider Number
260065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/30/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Mercy Hospital Springfield
William J Roberts, Vice President Finance
(417) 820-7363
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
3050 E RIVER BLUFF BLVD
OZARK, MO 65721-8807
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating 4/1/2015 until terminated effective 4/1/2015; reinstated effective 1/1/2018.
10/24/2017
June 2025
June 2025
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