340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CAH261307-02 GENERAL JOHN J. PERSHING MEMORIAL HOSPITAL (Terminated)
Print
Main Details
Name
GENERAL JOHN J. PERSHING MEMORIAL HOSPITAL
Subdivision Name
GENERAL JJPM HOSPITAL ASSOCIATION - family practice
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH261307-02
Medicare Provider Number
261307
Outpatient Facility Provider Number
268669
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/30/2020
Last Recertification Date
8/23/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Pershing Health System
Karla Clubine, CEO
(660) 258-1141
Primary Contact
GENERAL JOHN J. PERSHING MEMORIAL HOSPITAL
BRIAN CASEBOLT, DIRECTOR OF PHARMACY
(660) 258-1161
Addresses
Street Address
125 EAST LOCKLING ST
APPLEGATE MEDICAL GROUP
BROOKFIELD, MO 64628-2367
Billing Address
Same as Street Address
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