# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AVERA MEDICAL GROUP ROCK RAPIDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003389206
- **Authorized official:** RONALD J. PLACE MD (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7903

## Contact information

- **Practice address:** 1100 S 10TH AVE, STE 100, ROCK RAPIDS, IA 51246-2020
- **Practice address phone:** (712) 472-5300
- **Mailing address:** PO BOX 5045, CBO PRV ENRLMT PALM PLACE, SIOUX FALLS, SD 57117-5045
- **Mailing address phone:** (605) 322-6428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/10/2019
- **Last updated:** 09/14/2023