340B Drug Pricing Program Database
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CAH431340-00 AVERA QUEEN OF PEACE (Active)
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Main Details
Name
AVERA QUEEN OF PEACE
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH431340-00
Medicare Provider Number
431340
Additional Details
Current Program Status
Active
Registration Date
4/4/2023
Participating Start Date
4/5/2023
Participating Approval Date
4/5/2023
Last Recertification Date
8/28/2024
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
525 North Foster
Mitchell, SD 57301
Billing Address
Avera Queen of Peace
525 North Foster
Mitchell, SD 57301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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