340B Drug Pricing Program Database
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DSH260141CU University of Missouri Health Care (Terminated)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
MIZZOU THERAPY SERVICES PROVIDENCE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141CU
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/27/2017
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Missouri Health Care
KERI SIMON, Chief Operating Officer, Hospital Services
(573) 882-8359
Primary Contact
University of Missouri Health Care
Jacob Simons, Pharmacy Business Director
(573) 884-4614
Addresses
Street Address
3916 S PROVIDENCE RD, STE 103
COLUMBIA, MO 65203-7152
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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