340B Drug Pricing Program Database
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DSH260065AL MERCY HOSPITAL SPRINGFIELD (Active)
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Main Details
Name
MERCY HOSPITAL SPRINGFIELD
Subdivision Name
MERCY NATIONAL - Mercy Advanced Outpatient Care National
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH260065AL
Medicare Provider Number
260065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/16/2023
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Mercy Hospital Springfield
William J Roberts, Vice President Finance
(417) 820-7363
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
3045 S NATIONAL AVE
SPRINGFIELD, MO 65804-4268
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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