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SHERRI'S PHARMACY SERVICE, INC.
DSH260006 HEARTLAND REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HEARTLAND REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260006
Entity Address
5325 FARAON
ST. JOSEPH, MO 64506-3398
Medicare Provider Number
260006
Participating Start Date
1/1/2024
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
SHERRI'S PHARMACY SERVICE, INC.
Pharmacy Address
DBA SHERRI'S PHARMACY SERVICES
108 S. MAIN ST.
PO BOX 267
GRANT CITY, MO 64456-0267
Pharmacy Comments
06/25/2012 changed address (was 108 E. 1ST ST., STE. A)
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Dwain Stilson, Chief Financial Officer
(816) 271-7070
Contract Pharmacy Representative
Sherri's Pharmacy
Sherri James, owner/Pharmacist in Charge
(660) 564-3784
Signed By Date
4/13/2020
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