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Organization
AVERA ST LUKES
Active
Organization
AVERA ST LUKES
Active
Parent organization
HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOSPITAL
Authorized official
RONALD L JACOBSON (CEO)
(605) 622-5125
Entity
Organization
Contact information
Practice address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5000
(605) 622-5255
Mailing address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5000
(605) 622-5255
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
10525
SD
3336I0012X
Institutional Pharmacy
10525
SD
335E00000X
Prosthetic/Orthotic Supplier
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9163240
—
SD
Enumeration date
08/18/2006
Last updated
10/22/2007
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