340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SCH430012-12 AVERA SACRED HEART HOSPITAL (Terminated)
Print
Main Details
Name
AVERA SACRED HEART HOSPITAL
Subdivision Name
Avera Medical Group Behavioral Health Yankton
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH430012-12
Medicare Provider Number
430012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2022
Participating Start Date
4/21/2022
Participating Approval Date
4/21/2022
Last Recertification Date
8/20/2023
Termination Date
Termination Reason
1/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Avera
Melissa Goff, Vice President - Pharmacy
(605) 322-8548
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
409 Summit
#3200
Yankton, SD 57078
Billing Address
Avera Sacred Heart Hospital
501 Summit
Yankton, SD 57078
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
3
of
3
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
3
of
3
Page:
of 1
Go
Page size:
Change
Participating Start Date 4/1/2021, Termination Date 4/1/2022, Reinstatement 4/21/2022
04/21/2022
Participating Start Date 4/1/2021, Termination Date 4/1/2022, Reinstatement 7/1/2022
04/14/2022
Participating from effective date: (07/01/2019) until terminated effective date: (1/1/2020), reinstatement effective date: (04/01/2021).
01/13/2021
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
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