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SCH430048 MONUMENT HEALTH SPEARFISH HOSPITAL (Terminated)
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Main Details
Name
MONUMENT HEALTH SPEARFISH HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH430048
Medicare Provider Number
430048
Additional Details
Current Program Status
Terminated
Registration Date
2/5/2020
Participating Start Date
3/15/2022
Participating Approval Date
2/24/2020
Last Recertification Date
9/1/2023
Termination Date
Termination Reason
1/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Monument Health
Thomas Worsley, President
(605) 644-4091
Primary Contact
Monument Health
Kami Haupt, 340B Supervisor
(605) 755-7184
Addresses
Street Address
1440 NORTH MAIN
SPEARFISH, SD 57783
Billing Address
Monument Health
PO Box 6000
Accounts Payable
Rapid City, SD 57709
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 4/1/2019; Termination date 3/31/2020. Reinstatement 4/1/2020.
02/10/2020
April 2025
April 2025
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