340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH260070J PEMISCOT COUNTY MEMORIAL HOSPITAL (Active)
Print
Main Details
Name
PEMISCOT COUNTY MEMORIAL HOSPITAL
Subdivision Name
Physicians Diagnostic Center - Advanced Diagnostic Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260070J
Medicare Provider Number
260070
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/21/2017
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Pemiscot Memorial Health Systems
DAVID KETCHUM, CEO
(573) 359-3579
Primary Contact
PEMISCOT MEMORIAL HEALTH SYSTEMS
Loren Clifton, Pharmacy Technican
(573) 359-3612
Addresses
Street Address
225 North Hwy J
Hayti, MO 63851
Billing Address
Physicians Diagnostic Center
PO BOX 489
Hayti, MO 63851
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session