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CH07137S Southeast Missouri Health Network (Terminated)
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Main Details
Name
Southeast Missouri Health Network
Subdivision Name
Caruthersville Dental Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-021958
340B ID
CH07137S
Grant Number
H80CS00557
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2018
Participating Start Date
1/1/2019
Participating Approval Date
11/7/2018
Last Recertification Date
2/9/2022
Termination Date
Termination Reason
4/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
SEMO Health Network
CHRIS JONES, CEO
(573) 313-2501
Primary Contact
Southeast Missouri Health Network
Aaron Girffin, Policy Director
(573) 313-2501
Addresses
Street Address
109 East Fifth St
Caruthersville, MO 63830-1417
Billing Address
SEMO Health Network
6738 St. Hwy. 77
Benton, MO 63736
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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