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BLUE SPRINGS PRICE CHOPPER PH
DSH260102 Truman Medical Center, Incorporated dba University Health Lakewood Medical Center
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Covered Entity Details
Entity Name
Truman Medical Center, Incorporated dba University Health Lakewood Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260102
Entity Address
7900 Lee's Summit Road
Kansas City, MO 64139
Medicare Provider Number
260102
Participating Start Date
4/1/2001
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
BLUE SPRINGS PRICE CHOPPER PH
Pharmacy Address
1101 S 7 HIGHWAY
BLUE SPRINGS, MO 64014-3204
Pharmacy Comments
Contract Details
Approval Date
4/9/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lynda Donegan, Vice President/Professional Health Services
(816) 404-3528 Ext: 8164043672
Contract Pharmacy Representative
Cosentino Group
Frank Wolff, Director of Pharmacy
(913) 749-1511
Signed By Date
4/9/2014
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