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CAH431310-00 Avera McKennan DBA Avera Flandreau Hospital (Active)
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Main Details
Name
Avera McKennan DBA Avera Flandreau Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH431310-00
Medicare Provider Number
431310
Additional Details
Current Program Status
Active
Registration Date
10/1/2010
Participating Start Date
1/1/2011
Participating Approval Date
10/15/2010
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
214 NORTH PRAIRIE STREET
FLANDREAU, SD 57028
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/25/11 updated entity name( was AVERA MCKENNAN DBA AVERA FLANDREAU MEDICAL CENTER) 12/21/11 added NPI #
12/21/2011
7/25/11 updated entity name( was AVERA MCKENNAN DBA AVERA FLANDREAU MEDICAL CENTER)
07/25/2011
April 2025
April 2025
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