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MISSOURI CVS PHARMACY, L.L.C.
DSH260048 Truman Medical Center, Incorporated dba University Health Truman Medical Center
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Covered Entity Details
Entity Name
Truman Medical Center, Incorporated dba University Health Truman Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260048
Entity Address
2301 Holmes Street
Kansas City, MO 64108
Medicare Provider Number
260048
Participating Start Date
12/1/1992
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10241
1315 WEST 23RD ST.
INDEPENDENCE, MO 64050
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Wilson, Chief Financial Officer
(816) 404-2544
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2022
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