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CH07137AA Southeast Missouri Health Network (Active)
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Main Details
Name
Southeast Missouri Health Network
Subdivision Name
SEMO Health Network Benton Corporate Office
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017110
340B ID
CH07137AA
Grant Number
H80CS00557
Additional Details
Current Program Status
Active
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/15/2021
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
SEMO Health Network
CHRIS JONES, CEO
(573) 313-2501
Primary Contact
Southeast Missouri Health Network
Mallory Matthews, Chief Clinical Officer
(573) 313-2500
Addresses
Street Address
6738 State Highway 77
Benton, MO 63736-8238
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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