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DSH260065AC MERCY HOSPITAL SPRINGFIELD (Active)
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Main Details
Name
MERCY HOSPITAL SPRINGFIELD
Subdivision Name
Mercy Gastrointestinal Endoscopy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260065AC
Medicare Provider Number
260065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/13/2018
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Mercy Hospital Springfield
William J Roberts, Vice President Finance
(417) 820-7363
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
2115 S FREMONT
SUITE 1300
Springfield, MO 65804
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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