340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVERA SPECIALTY PHARMACY
CAH431327-00 St. Michael's Hospital, Inc.
Print
Covered Entity Details
Entity Name
St. Michael's Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431327-00
Entity Address
410 W 16th Ave
Tyndall, SD 57066-2318
Medicare Provider Number
431327
Participating Start Date
4/1/2013
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
AVERA SPECIALTY PHARMACY
Pharmacy Address
500 E 56TH ST N STE 3150
SIOUX FALLS, SD 57104
Pharmacy Comments
5/4/11 UPDATED NAME AND ADDR (WAS AVERA DOCTORS PLAZA 2 PHARMACY, 1100 EAST 21ST STREET, SUITE 200)
Contract Details
Approval Date
1/10/2023
Contract Begin Date
1/17/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ashli Danilko, CEO
(605) 589-2100
Contract Pharmacy Representative
Avera McKennan
David Flicek, Avera McKennan President/CEO
(605) 322-7916
Signed By Date
1/10/2023
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