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CH07137Y Southeast Missouri Health Network (Active)
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Main Details
Name
Southeast Missouri Health Network
Subdivision Name
Sikeston High School Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029714
340B ID
CH07137Y
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
200 Pine St
Sikeston, MO 63801-3258
Billing Address
SEMO Health Network Corporate Office
6738 St. Hwy 77
Benton, MO 63736
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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