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DSH430027AH Sanford USD Medical Center (Active)
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Main Details
Name
Sanford USD Medical Center
Subdivision Name
Sanford 69th & Minnesota Acute Care and Orthopedic Fast Track Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH430027AH
Medicare Provider Number
430027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/26/2014
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
6110 S MINNESOTA AVE.
SIOUX FALLS, SD 57108-2571
Billing Address
Sanford USD Medical Center
1305 W 18th St
Sioux Falls, SD 57117-5039
Comments
Medicaid Billing
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Contract Pharmacies
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