340B Drug Pricing Program Database
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DSH430027AW Sanford USD Medical Center (Terminated)
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Main Details
Name
Sanford USD Medical Center
Subdivision Name
SANFORD MEDICAL CENTER / Sanford Children's Residency Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH430027AW
Medicare Provider Number
430027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/11/2015
Last Recertification Date
11/7/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Sanford Health
Cole A Turner, Vice President, Finance
(605) 328-6940
Primary Contact
Sanford USD Medical Center
MICHAEL DUNCAN, PHARMACY DIRECTOR
(605) 333-6531
Addresses
Street Address
6101 S LOUISE AVE
SANFORD CHILDREN'S RESIDENCY CLINIC
SIOUX FALLS, SD 57108-5981
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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