340B Drug Pricing Program Database
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CAH161336-01 Hegg Memorial Hospital (Terminated)
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Main Details
Name
Hegg Memorial Hospital
Subdivision Name
Hegg Medical Clinic Avera
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161336-01
Medicare Provider Number
161336
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/31/2012
Participating Start Date
4/1/2012
Participating Approval Date
2/22/2012
Last Recertification Date
8/28/2018
Termination Date
Termination Reason
4/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Hegg Memorial Hospital
Glenn Zevenbergen, CEO
(712) 476-8009
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
1200 21st Avenue
Rock Valley, IA 51247
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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