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DSH260113AA MISSOURI DELTA MEDICAL CENTER (Active)
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Main Details
Name
MISSOURI DELTA MEDICAL CENTER
Subdivision Name
MISSOURI DELTA PHYSICIAN SERVICES - GYN/ONCOLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH260113AA
Medicare Provider Number
260113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/4/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Missouri Delta Medical Center
JASON SCHRUMPF, CEO
(573) 472-7600
Primary Contact
Missouri Delta Medical Center
Christopher White, Director of Pharmacy
(573) 472-7450
Addresses
Street Address
201 PLAZA DR
C
SIKESTON, MO 63801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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