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DSH260141CW University of Missouri Health Care (Terminated)
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Main Details
Name
University of Missouri Health Care
Subdivision Name
WCH Med/Surgery Unit
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260141CW
Medicare Provider Number
260141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/15/2019
Last Recertification Date
9/18/2022
Termination Date
Termination Reason
7/1/2023
Site closure
Contacts
Authorizing Official
University of Missouri Health Care
Katrina Lambrecht, Chief Operating Officer
(573) 882-6467
Primary Contact
University of Missouri Health Care
Jacob Simons, Pharmacy Business Director
(573) 884-4614
Addresses
Street Address
404 N. Keene Street
Columbia, MO 65201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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