340B Drug Pricing Program Database
WHITE DRUG #61
CAH431320-00 MONUMENT HEALTH LEAD-DEADWOOD HOSPITAL - information as of 4/25/2025 8:50:25 PM
Covered Entity Details
Entity Name
MONUMENT HEALTH LEAD-DEADWOOD HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431320-00
Entity Address
61 CHARLES ST
DEADWOOD, SD 57732
Medicare Provider Number
431320
Participating Start Date
1/1/2011
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
WHITE DRUG #61
Pharmacy Address
706 38TH ST NW UNIT A
FARGO, ND 58102
Pharmacy Comments
Contract Details
Approval Date
9/12/2012
Contract Begin Date
9/12/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sherry Bea Smith, CEO-Lead-Deadwood Regional Hospital
(605) 719-6122
Contract Pharmacy Representative
Thrifty White
Timothy Weippert, EVP of Pharmacy
(763) 513-4365
Signed By Date
8/14/2012
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