340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SHOPKO PHARMACY #2745
CAH431338-00 Avera McKennan dba Avera Gregory Hospital
Print
Covered Entity Details
Entity Name
Avera McKennan dba Avera Gregory Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431338-00
Entity Address
110 S. Logan Ave
Gregory, SD 57533
Medicare Provider Number
431338
Participating Start Date
10/1/2011
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
SHOPKO PHARMACY #2745
Pharmacy Address
1140 E 5TH ST
WINNER, SD 57580
Pharmacy Comments
Contract Details
Approval Date
7/9/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/18/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Anthony Timanus, CEO/Administrator
(605) 835-5108
Contract Pharmacy Representative
ShopKo
Lorie Neumann, Contracting & Compliance
(920) 429-4726
Signed By Date
7/9/2015
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