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CAH431324-00 AVERA WESKOTA MEMORIAL MEDICAL CENTER (Active)
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Main Details
Name
AVERA WESKOTA MEMORIAL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH431324-00
Medicare Provider Number
431324
Additional Details
Current Program Status
Active
Registration Date
7/6/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/19/2021
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
604 1ST STREET NE
WESSINGTON SPRINGS, SD 57382
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 7/1/2012, Termination 1/1/2013, Reinstatement 10/1/2021
07/16/2021
April 2025
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