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DSH430015 AVERA ST. MARY'S (Active)
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Main Details
Name
AVERA ST. MARY'S
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH430015
Medicare Provider Number
430015
Additional Details
Current Program Status
Active
Registration Date
10/20/2006
Participating Start Date
10/1/2014
Participating Approval Date
10/24/2006
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Avera
Melissa Goff, Vice President - Pharmacy
(605) 322-8548
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
801 E SIOUX
PIERRE, SD 57501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Hospital was participating 1/1/2007 through 9/30/2013; terminated effective 10/1/2013 due to its DSH adjustment percentage falling below the statutory threshold. Participation has been reinstated effective 10/1/2014.
10/20/2014
Hospital was participating 1/1/2007 through 9/30/2014; terminated effective 10/1/2013 due to its DSH adjustment percentage falling below the statutory threshold. Participation has been reinstated effective 10/1/2014.
09/30/2014
April 2025
April 2025
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