340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CAH431306-03 Platte Community Memorial Hospital, Inc. (Active)
Print
Main Details
Name
Platte Community Memorial Hospital, Inc.
Subdivision Name
White Lake Medical Clinic
Type
Critical Access Hospital
Rural
No
340B ID
CAH431306-03
Medicare Provider Number
431306
Outpatient Facility Provider Number
433439
Additional Details
Current Program Status
Active
Registration Date
1/10/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/21/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Platte Community Memoria Hospial Inc
Mark Burket, CEO
(605) 337-3364
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
306 South Johnston Street
White Lake, SD 57383
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session