340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LEWIS DRUG #10
CAH161336-00 Hegg Memorial Hospital
Print
Covered Entity Details
Entity Name
Hegg Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161336-00
Entity Address
1202 21st Ave
Rock Valley, IA 51247
Medicare Provider Number
161336
Participating Start Date
10/1/2011
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
LEWIS DRUG #10
Pharmacy Address
6109 S LOUISE AVE
SIOUX FALLS, SD 57108
Pharmacy Comments
4/19/11 CORRECTED ADDR (WAS 3109 S. LOUISE AVENUE)
Contract Details
Approval Date
4/15/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/20/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Glenn Zevenbergen, CEO
(712) 476-8009
Contract Pharmacy Representative
Dan Peterson, Pharmacist
(605) 367-2510
Signed By Date
4/15/2013
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