# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Elkton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760560452
- **Authorized official:** MRS. JULIE N. NORTON (SENIOR VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (605) 322-6375

## Contact information

- **Practice address:** 203 N ELK ST, ELKTON, SD 57026-2124
- **Practice address phone:** (605) 542-7701
- **Practice address fax:** (605) 542-7291
- **Mailing address:** 212 N PRAIRIE ST, FLANDREAU, SD 57028-1243
- **Mailing address phone:** (605) 997-2741
- **Mailing address fax:** (605) 997-2418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 02/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0571919 | — | IA |
| 05 | — | 10025371500 | — | NE |
| 01 | — | 106366608 | DEPARTMENT OF LABOR | SD |
| 05 | — | 126277700 | — | MN |
| 01 | — | 659S2FL | BCBS OF MN | MN |
| 05 | — | 80484900 | — | WI |
| 01 | — | 9216572 | DAKOTCARE | SD |
| 01 | — | 95027 | HEALTHPARTNERS | SD |
| 01 | — | AH908107523 | PREFERRED ONE | SD |