340B Drug Pricing Program Database
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DSH260137AU FREEMAN HEALTH SYSTEM (Terminated)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
PAIN MANAGEMENT CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137AU
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/5/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/28/2015
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
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
3103 MCCLELLAND BLVD
JOPLIN, MO 64804-1604
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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