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CAH431326-00 Milbank Area Hospital Avera (Active)
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Main Details
Name
Milbank Area Hospital Avera
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH431326-00
Medicare Provider Number
431326
Additional Details
Current Program Status
Active
Registration Date
9/27/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/2/2010
Last Recertification Date
8/22/2024
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
301 Flynn Drive
MILBANK, SD 57252
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/28/11 updated entity addr (was 901 VIRGIL AVENUE) 7/25/11 updated name(was MILBANK AREA HOSPITAL AVERA) 1/25/12 added NPI #
03/28/2012
7/25/11 updated name(was MILBANK AREA HOSPITAL AVERA) 1/25/12 added NPI #
01/25/2012
7/25/11 updated name(was MILBANK AREA HOSPITAL AVERA)
07/25/2011
April 2025
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