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Organization
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
Active
Organization
SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC
Active
Other names
AVERA ENDOSCOPY/SURGICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY W OLSON (GENERAL MANAGER)
(605) 229-1367
Entity
Organization
Contact information
Practice address
310 S PENNSYLVANIA ST, SUITE 201, ABERDEEN, SD 57401-4553
(605) 229-1367
(605) 229-1002
Mailing address
310 S PENNSYLVANIA ST, SUITE 201, ABERDEEN, SD 57401-4553
(605) 229-1367
(605) 229-1002
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
48090
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5490320
—
SD
Enumeration date
12/21/2005
Last updated
04/14/2009
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