340B Drug Pricing Program Database
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CAH431330-00 Avera St. Benedict Health Center (Active)
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Main Details
Name
Avera St. Benedict Health Center
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH431330-00
Medicare Provider Number
431330
Additional Details
Current Program Status
Active
Registration Date
1/2/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/14/2013
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
401 WEST GLYNN DRIVE
PARKSTON, SD 57366
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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