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DSH260137AT FREEMAN HEALTH SYSTEM (Active)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
GENERAL & VASCULAR SURGICAL GROUP
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137AT
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/28/2015
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
3302 MCINTOSH CIR
STE 1
JOPLIN, MO 64804-3648
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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