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OMNICARE OF KANSAS CITY
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
OMNICARE OF KANSAS CITY
Pharmacy Address
OMINCARE PHARMACY OF THE MIDWEST LLC
10400 HICKMAN MILLS DR, SUITE 200
KANSAS CITY, MO 64137
Pharmacy Comments
Contract Details
Approval Date
7/2/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dean Ohmart, Chief Financial Officer
(660) 262-7307
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/2/2021
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