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DSH430027K Sanford USD Medical Center (Active)
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Main Details
Name
Sanford USD Medical Center
Subdivision Name
Sanford Dermatology Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH430027K
Medicare Provider Number
430027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/19/2012
Last Recertification Date
9/3/2024
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
1310 W 22nd Street
1st Floor
Sioux Falls, SD 57105
Billing Address
Sanford USD Medical Center
1305 W 18th St
Sioux Falls, SD 57117-5039
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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