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CAH241315-00 SANFORD JACKSON MEDICAL CENTER (Active)
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Main Details
Name
SANFORD JACKSON MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241315-00
Medicare Provider Number
241315
Additional Details
Current Program Status
Active
Registration Date
11/29/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/29/2010
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Sanford Health
Eric Lucas Vanden Hull, Vice President of Finance - Sioux Falls HSD
(712) 261-5275
Primary Contact
Sanford USD Medical Center
Alyssa O Howard, Director of Pharmacy
(605) 695-1697
Addresses
Street Address
1430 NORTH HWY
JACKSON, MN 56143
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/24/12 - Updated entity addr (was SANFORD MEDICAL CENTER JACKSON)
02/24/2012
June 2025
June 2025
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