340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MITCHELL'S DRUG STORES ON THE BOULEVARD
CAH261331-00 FREEMAN NEOSHO HOSPITAL
Print
Covered Entity Details
Entity Name
FREEMAN NEOSHO HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH261331-00
Entity Address
113 W. HICKORY STREET
NEOSHO, MO 64850
Medicare Provider Number
261331
Participating Start Date
9/20/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
MITCHELL'S DRUG STORES ON THE BOULEVARD
Pharmacy Address
TIM MITCHELL MEDICAL INC
719 S. NEOSHO BLVD
SUITE A
NEOSHO, MO 64850-2007
Pharmacy Comments
Contract Details
Approval Date
7/8/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
STEVE GRADDY, CFO
(417) 347-6678
Contract Pharmacy Representative
Tim Mitchell, Owner
(417) 451-9501
Signed By Date
7/8/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session