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Organization
AVERA MCKENNAN
Active
Organization
AVERA MCKENNAN
Active
Parent organization
AVERA MCKENNAN
Other names
Avera CNOS Northside DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVERA MCKENNAN
Authorized official
RONALD PLACE MD (REGIONAL PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
2735 OUTER DR N, SIOUX CITY, IA 51104-1590
(605) 217-2667
Mailing address
575 N SIOUX POINT RD, DAKOTA DUNES, SD 57049-5312
(605) 217-2667
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
08/10/2026
Last updated
08/31/2026
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