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M ROGERS INC & SUBSIDIARY
SCH260006-00 HEARTLAND REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HEARTLAND REGIONAL MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260006-00
Entity Address
5325 FARAON
ST. JOSEPH, MO 64506-3398
Medicare Provider Number
260006
Participating Start Date
10/1/2020
Last Recertification Date
8/30/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
M ROGERS INC & SUBSIDIARY
Pharmacy Address
ROGERS PHARMACY
125 E SOUTH AVE
MARYVILLE, MO 64468
Pharmacy Comments
Contract Details
Approval Date
7/13/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John P. Wilson, Chief Financial Officer
(816) 271-6611
Contract Pharmacy Representative
Rogers Pharmacy
Benne Rogers, Owner & CFO
(816) 232-3348
Signed By Date
7/13/2016
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