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KILGORE INC. (KILGORE'S MEDICAL PHARMACY
DSH260141 University of Missouri Health Care
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Covered Entity Details
Entity Name
University of Missouri Health Care
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260141
Entity Address
One Hospital Drive
Columbia, MO 65212
Medicare Provider Number
260141
Participating Start Date
12/1/1992
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
KILGORE INC. (KILGORE'S MEDICAL PHARMACY
Pharmacy Address
109B EASTSIDE DR
ASHLAND, MO 65010
Pharmacy Comments
Contract Details
Approval Date
10/7/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Curtright, CEO
(573) 884-8738
Contract Pharmacy Representative
KILGORE'S MEDICAL PHARMACY
WILLIAM MORRISSEY, PRESIDENT
(573) 442-0194
Signed By Date
10/7/2020
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