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SWEET SPRINGS PHARMACY INC
SCH260097-00 WESTERN MISSOURI MEDICAL CENTER
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Covered Entity Details
Entity Name
WESTERN MISSOURI MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260097-00
Entity Address
403 BURKARTH ROAD
WARRENSBURG, MO 64093
Medicare Provider Number
260097
Participating Start Date
10/1/2015
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
SWEET SPRINGS PHARMACY INC
Pharmacy Address
401 S LOCUST ST
SWEET SPRINGS, MO 65351
Pharmacy Comments
Contract Details
Approval Date
7/1/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dean Ohmart, Chief Financial Officer
(660) 262-7307
Contract Pharmacy Representative
The Market
Tony Clark, Director of Operations
(660) 247-1580
Signed By Date
7/1/2020
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