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CAH281329-00 AVERA ST. ANTHONY'S HOSPITAL (Active)
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Main Details
Name
AVERA ST. ANTHONY'S HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH281329-00
Medicare Provider Number
281329
Additional Details
Current Program Status
Active
Registration Date
11/26/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/7/2010
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
300 NORTH 2ND ST
O'NEILL, NE 68763
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/24/12 - added NPI #
02/24/2012
April 2025
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