340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SCH260195-01 CITIZENS MEMORIAL HOSPITAL DISTRICT (Terminated)
Print
Main Details
Name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Subdivision Name
CMH Surgical Services - CMH Surgical Services
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH260195-01
Medicare Provider Number
260195
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2021
Participating Start Date
11/1/2021
Participating Approval Date
11/1/2021
Last Recertification Date
Termination Date
Termination Reason
4/1/2022
Change of covered entity type
Contacts
Authorizing Official
Citizens Memorial Hospital
Renee Marie Meyer, Chief Financial Officer
(417) 328-6258
Primary Contact
Citizens Memorial Hospital District
Tim Wolters, Director of Reimbursement
(417) 328-7286
Addresses
Street Address
1155 West Parkview Street, Suite 1F
Bolivar, MO 65613
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