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DSH260137BF FREEMAN HEALTH SYSTEM (Active)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
CLINIC OF CARTHAGE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137BF
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/4/2016
Last Recertification Date
9/3/2024
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
719 WEST CENTENNIAL
CARTHAGE, MO 64836-2816
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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