340B Drug Pricing Program Database
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DSH260137BN FREEMAN HEALTH SYSTEM (Terminated)
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Main Details
Name
FREEMAN HEALTH SYSTEM
Subdivision Name
Lithotripsy - Lithotripsy East Campus
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260137BN
Medicare Provider Number
260137
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/28/2020
Last Recertification Date
9/1/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Freeman Health System
Jeff Thompson, Chief Clinical Officer
(417) 347-3563
Primary Contact
Freeman Health System
Greg Cobble, Director of Retail Pharmacy Operations
(417) 347-3078
Addresses
Street Address
3105 McClelland BLVD
Joplin, MO 64804-3932
Billing Address
Freeman Health System
1102 W 32nd St
Joplin, MO 64804
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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