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LEWIS DRUG #4
CAH431335-00 HURON REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HURON REGIONAL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431335-00
Entity Address
172 4TH ST. SE
HURON, SD 57350-2590
Medicare Provider Number
431335
Participating Start Date
9/30/2010
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
LEWIS DRUG #4
Pharmacy Address
1950 DAKOTA AVE S
HURON, SD 57350-4026
Pharmacy Comments
Contract Details
Approval Date
7/8/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marcia m Zwanziger, SENIOR VP-FINANCE
(605) 353-6517
Contract Pharmacy Representative
Lewis Drug
Scott Cross, EVP
(605) 367-2800
Signed By Date
7/8/2020
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