# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AVERA LONG TERM CARE PHARMACY RAPID CITY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306601794
- **Authorized official:** RONALD J. PLACE (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7903

## Contact information

- **Practice address:** 2801 PLANT ST, RAPID CITY, SD 57702-0304
- **Practice address phone:** (605) 322-1450
- **Practice address fax:** (605) 322-1451
- **Mailing address:** PO BOX 5045, CBO PROV ENRLMT, SIOUX FALLS, SD 57117-5045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2024
- **Last updated:** 02/15/2024