340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVERA MCKENNAN
DSH430016 AVERA MCKENNAN
Print
Covered Entity Details
Entity Name
AVERA MCKENNAN
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH430016
Entity Address
1325 S. CLIFF AVE.
SIOUX FALLS, SD 57105
Medicare Provider Number
430016
Participating Start Date
9/18/2008
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
AVERA MCKENNAN
Pharmacy Address
DBA AVERA 69TH STREET PHARMACY
4400 W 69TH ST STE 300
SIOUX FALLS, SD 57108-8170
Pharmacy Comments
Contract Details
Approval Date
11/7/2011
Contract Begin Date
11/7/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/7/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVE KAPASKA, REGIONAL PRESIDENT/CEO
(605) 322-7808
Contract Pharmacy Representative
DAVE KAPASKA, REGIONAL PRESIDENT/CEO
(605) 322-7808
Signed By Date
11/2/2011
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