# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Specialty Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346266202
- **Authorized official:** MR. RONALD JOSPEH PLACE MD (PRESIDENT/CEO)
- **Authorized official phone:** (605) 322-7903

## Contact information

- **Practice address:** 4101 W MEMORY CIR STE 135, SIOUX FALLS, SD 57107-6503
- **Practice address phone:** (605) 322-8300
- **Practice address fax:** (605) 322-8361
- **Mailing address:** 500 E 56TH ST N STE 3150, SIOUX FALLS, SD 57104-0408
- **Mailing address phone:** (605) 322-8300
- **Mailing address fax:** (605) 322-8361

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | 261725 | MN | — |
| 3336C0003X | Community/Retail Pharmacy | 3254 | IA | — |
| 3336S0011X | Specialty Pharmacy | 100-1867 | SD | Yes |
| 3336S0011X | Specialty Pharmacy | 30747 | TX | — |
| 3336S0011X | Specialty Pharmacy | 637 | NE | — |
| 3336S0011X | Specialty Pharmacy | PHAR396 | ND | — |
| 3336S0011X | Specialty Pharmacy | Y006781 | AZ | — |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 07/24/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100261606-00 | — | NE |
| 05 | — | 1346266202 | — | IA |
| 05 | — | 1346266202 | — | MN |
| 01 | — | 2094315 | PK | — |
| 05 | — | 8504220 | — | SD |