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ARJ INFUSION SERVICES, LLC
HM57117 SANFORD USD MEDICAL CENTER SIOUX FALLS
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Covered Entity Details
Entity Name
SANFORD USD MEDICAL CENTER SIOUX FALLS
Subdivision Name
SD CHILDREN'S SPECIALTY CLINICS
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM57117
Entity Address
1600 W 22nd St.
SIOUX FALLS, SD 57117
Grant Number
H30MC24052
Participating Start Date
1/1/2024
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
ARJ INFUSION SERVICES, LLC
Pharmacy Address
3730 S 149TH ST
STE. 102
OMAHA, NE 68144
Pharmacy Comments
Contract Details
Approval Date
4/11/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Lucas Vanden Hull, Vice President of Finance - Sioux Falls HSD
(712) 261-5275
Contract Pharmacy Representative
ARJ Infusion Services
Mitchell Clevenger, Vice President of Business Development
(913) 702-6250
Signed By Date
4/11/2024
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