Covered Entity Details

CAH241371-00 SANFORD MEDICAL CENTER LUVERNE (Active) - information as of 6/16/2025 1:02:27 AM

Main Details

Name

SANFORD MEDICAL CENTER LUVERNE

Subdivision Name

Type

Critical Access Hospital

Rural

340B ID

CAH241371-00

Medicare Provider Number

241371

Additional Details

Current Program Status

Active

Registration Date

9/2/2010

Participating Start Date

1/1/2011

Participating Approval Date

10/28/2010

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

Sanford Health
Eric Lucas Vanden Hull, Vice President of Finance - Sioux Falls HSD
(712) 261-5275

Primary Contact

Sanford USD Medical Center
Alyssa O Howard, Director of Pharmacy
(605) 695-1697

Addresses

Street Address

1600 N KNISS AVENUE
LUVERNE, MN 56156

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	LEWIS DRUG DISTRIBUTION CENTER	700 E 54TH ST N	SIOUX FALLS	SD	57104	01/13/2014	04/01/2014	01/01/2020	06/03/2020
Contract Detail	LEWIS FAMILY DRUG #51	202 S KNISS AVE	LUVERNE	MN	56156-1775	07/09/2013	10/01/2013		07/09/2013
Contract Detail	STERLING DRUG	209 MAINE AVE STE 105	ADRIAN	MN	56110-1071	07/11/2022	10/01/2022		10/01/2022

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH241371-01	Child	CAH	SANFORD MEDICAL CENTER LUVERNE	Sanford Luverne Clinic	1601 Sioux Valley Drive	Luverne	MN	Active
CAH241371-02	Child	CAH	SANFORD MEDICAL CENTER LUVERNE	Sanford Luverne Specialty Clinic - Specialties	1601 Sioux Valley Drive	Luverne	MN	Active
CAH241371-03	Child	CAH	SANFORD MEDICAL CENTER LUVERNE	Sanford Luverne Womens Health Clinic - OB/Gyn	1601 Sioux Valley Drive	Luverne	MN	Active
CAH241371-04	Child	CAH	SANFORD MEDICAL CENTER LUVERNE	Sanford Luverne General Surgery Clinic - Surgery	1601 Sioux Valley Drive	Luverne	MN	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/5/2023 10:59:25 AM	9/3/2024 6:00:36 PM	9/3/2024 6:00 PM
Details	Last Recertification Date	Update	Recertification	9/13/2022 12:56:42 PM	9/5/2023 10:59:25 AM	9/5/2023 10:59 AM
Contacts	Authorizing Official	Update	Change Request	NELSON, ALLISON Director of Finance Sanford Canby Medical Center 5072237277-273	Vanden Hull, Eric Lucas Vice President of Finance - Sioux Falls HSD Sanford Health 7122615275	3/24/2023 6:39 AM
Contacts	Primary Contact	Update	Change Request	Wrigg, Sarah Jean Pharm.D. Sanford Luverne Medical Center 5079357273	Howard, Alyssa O Director of Pharmacy Sanford USD Medical Center 6056951697	2/17/2023 6:27 AM
Contacts	Primary Contact	Update	Profile Change Request	Wrigg, Sarah Jean Pharm.D. Sanford Luverne Medical Center 5074491273	Wrigg, Sarah Jean Pharm.D. Sanford Luverne Medical Center 5079357273	11/22/2022 2:16 PM
Contacts	Primary Contact	Update	Change Request	Drenth, Emilly Pharmacy Manager Sanford Luverne Medical Center Pharmacy 5074491302	Wrigg, Sarah Jean Pharm.D. Sanford Luverne Medical Center 5074491273	10/4/2022 12:00 PM
Details	Last Recertification Date	Update	Recertification	8/25/2021 12:35:37 PM	9/13/2022 12:56:42 PM	9/13/2022 12:56 PM
Contacts	Authorizing Official	Update	Profile Change Request	NELSON, ALLISON Director of Fiscal Services Sanford Canby Medical Center 5072237277-273	NELSON, ALLISON Director of Finance Sanford Canby Medical Center 5072237277-273	2/1/2022 7:41 AM
Contacts	Primary Contact	Update	Change Request	AUSTIN, EMILLY PHARMACY MANAGER Sanford Luverne Medical Center Pharmacy 5074491302	Drenth, Emilly Pharmacy Manager Sanford Luverne Medical Center Pharmacy 5074491302	1/26/2022 7:19 AM
Details	Last Recertification Date	Update	Recertification	9/7/2020 9:34:41 AM	8/25/2021 12:35:37 PM	8/25/2021 12:35 PM
Details	Last Recertification Date	Update	Recertification	9/9/2019 9:12:22 AM	9/7/2020 9:34:41 AM	9/7/2020 9:34 AM
Contacts	Authorizing Official	Update	Change Request	Knobloch, Stan Director of Finance Sanford Health Network 7124726143	NELSON, ALLISON Director of Fiscal Services Sanford Canby Medical Center 5072237277-273	12/3/2019 2:09 PM
Details	Last Recertification Date	Update	Recertification	8/28/2018 7:10:01 AM	9/9/2019 9:12:22 AM	9/9/2019 9:12 AM
Contacts	Authorizing Official	Update	Profile Change Request	Knobloch, Stan Director of Fiscal Services Sanford Health Network 7124726143	Knobloch, Stan Director of Finance Sanford Health Network 7124726143	10/10/2018 5:00 PM
Details	Last Recertification Date	Update	Recertification	11/8/2017 11:14:28 AM	8/28/2018 7:10:01 AM	8/28/2018 7:10 AM
Details	Last Recertification Date	Update	Recertification	8/10/2016 12:00:00 AM	11/8/2017 11:14:28 AM	11/8/2017 11:14 AM
Contacts	Primary Contact	Update		AUSTIN, EMILLY PHARMACY MANAGER 5074491302	AUSTIN, EMILLY PHARMACY MANAGER Sanford Luverne Medical Center Pharmacy 5074491302	10/24/2017 3:19 PM
Contacts	Authorizing Official	Update	Profile Change Request	Knobloch, Stan Director of Fiscal Services Sanford Rock Rapids Medical Center 7124726143	Knobloch, Stan Director of Fiscal Services Sanford Health Network 7124726143	10/4/2017 12:14 PM
Contacts	Authorizing Official	Update	Profile Change Request	Knobloch, Stan CFO Sanford Rock Rapids Medical Center 7124726143	Knobloch, Stan Director of Fiscal Services Sanford Rock Rapids Medical Center 7124726143	10/4/2017 12:13 PM
Contacts	Authorizing Official	Update		Knobloch, Stan CFO 7124726143	Knobloch, Stan CFO Sanford Rock Rapids Medical Center 7124726143	10/4/2017 12:10 PM
Contacts	Authorizing Official	Insert			Knobloch, Stan CFO 7124726143	7/12/2017 5:21 PM
Addresses	Main Address	Insert			1600 N KNISS AVENUE LUVERNE, MN 56156	8/10/2016 11:08 AM
Contacts	Primary Contact	Update		AUSTIN, EMILLY PHARMACY MANAGER 5074491302	AUSTIN, EMILLY PHARMACY MANAGER 5074491302	8/10/2016 11:08 AM
Details	Last Recertification Date	Update		8/14/2015 12:00:00 AM	8/10/2016 12:00:00 AM	8/10/2016 11:07 AM
Details	Last Recertification Date	Update		8/7/2014 12:00:00 AM	8/14/2015 12:00:00 AM	8/14/2015 9:49 AM
Details	Last Recertification Date	Update		8/20/2013 11:36:43 AM	8/7/2014 12:00:00 AM	8/7/2014 4:42 PM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	8/20/2013 11:36:43 AM	8/20/2013 11:36 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	6/1/2012 10:06 AM
Contacts	Primary Contact	Insert			AUSTIN, EMILLY PHARMACY MANAGER 5074491302	12/14/2010 8:03 AM
Details	Last Recertification Date	Insert				12/14/2010 8:03 AM
Details	Grant Number	Insert				12/14/2010 8:03 AM
Details	340B ID	Insert			CAH241371-00	12/14/2010 8:03 AM
Details	Is Authorizing Official EHB Data	Insert				12/14/2010 8:03 AM
Dates	Last Date That 340B Drugs Purchased	Insert				12/14/2010 8:03 AM
Details	Medicare Provider Number	Insert			241371	12/14/2010 8:03 AM
Details	Entity Name	Insert			SANFORD MEDICAL CENTER LUVERNE	12/14/2010 8:03 AM
Details	Program Code	Insert			CAH	12/14/2010 8:03 AM
Details	Entity Subname	Insert				12/14/2010 8:03 AM
Dates	Participating Approval Date	Insert			10/28/2010 12:00:00 AM	12/14/2010 8:03 AM
Details	State	Insert			Active	12/14/2010 8:03 AM
Dates	Registration Date	Insert			9/2/2010 12:00:00 AM	12/14/2010 8:03 AM
Dates	Signed By Date	Insert			9/9/2010 12:00:00 AM	12/14/2010 8:03 AM
Dates	Start Date	Insert			1/1/2011 12:00:00 AM	12/14/2010 8:03 AM
Terminations	Termination Comments	Insert				12/14/2010 8:03 AM
Terminations	Termination Date	Insert				12/14/2010 8:03 AM
Terminations	Termination Effective Date	Insert				12/14/2010 8:03 AM
Terminations	Termination Reason	Insert				12/14/2010 8:03 AM