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CAH431327-00 St. Michael's Hospital, Inc. (Active)
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Main Details
Name
St. Michael's Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH431327-00
Medicare Provider Number
431327
Additional Details
Current Program Status
Active
Registration Date
1/10/2013
Participating Start Date
4/1/2013
Participating Approval Date
1/22/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
St. Michael's Hospital Avera
Ashli Danilko, CEO
(605) 589-2100
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
410 W 16th Ave
Tyndall, SD 57066-2318
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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