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DSH260137BE FREEMAN HEALTH SYSTEM (Terminated)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
OB/GYN ASSOCIATES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137BE
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/4/2016
Last Recertification Date
8/20/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Freeman Health System
STEVE GRADDY, CFO
(417) 347-6678
Primary Contact
Freeman Health System
Jeff Thompson, Chief Clinical Officer
(417) 347-3563
Addresses
Street Address
1500 S CASE ST
CARTHAGE, MO 64836-2813
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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