340B Drug Pricing Program Database

Name

BOTHWELL REGIONAL HEALTH CENTER

Subdivision Name

BRHC Cole Camp Clinic - Family Practice / OB

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH260009B

Medicare Provider Number

260009

Outpatient Facility Provider Number

Current Program Status

Active

Registration Date

7/13/2023

Participating Start Date

10/1/2023

Participating Approval Date

8/7/2023

Last Recertification Date

9/5/2024

Authorizing Official

Bothwell Regional Health Center
Steven R Davis, Chief Financial Officer
(660) 829-7790

Primary Contact

Bothwell Regional Health Center
Jill Renae Weller, 340B Program Coordinator
(660) 827-9492

Street Address

1201 E Main St.
Cole Camp, MO 65325

Billing Address

Bothwell Regional
601 E 14th St
Sedalia, MO 65301