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CAH431302-00 Avera Gettysburg dba Avera Missouri River Health Center (Active)
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Main Details
Name
Avera Gettysburg dba Avera Missouri River Health Center
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH431302-00
Medicare Provider Number
431302
Additional Details
Current Program Status
Active
Registration Date
2/22/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/4/2011
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
606 EAST GARFIELD
GETTYSBURG, SD 57442-1325
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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