340B Drug Pricing Program Database
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DSH430027DH Sanford USD Medical Center (Terminated)
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Main Details
Name
Sanford USD Medical Center
Subdivision Name
PULMONOLOGY WINDOM - PULMONOLOGY WINDOM
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH430027DH
Medicare Provider Number
430027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/15/2023
Last Recertification Date
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
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
2150 HOSPITAL DR
WINDOM, MN 56101
Billing Address
SANFORD USD MEDICAL CENTER
1305 W 18TH STREET
SIOUX FALLS, SD 57117-5039
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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