Organization
AVERA HOME MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA D DIELEMAN (PRESIDENT/CEO)
(605) 322-1872
Entity
Organization
Contact information
Practice address
109 3RD ST SE, HURON, SD 57350-2016
(605) 352-8290
(605) 352-8387
Mailing address
800 E 21ST ST, PO BOX 5045, SIOUX FALLS, SD 57105-1016
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
02007EST001
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9161263
—
SD
Enumeration date
11/28/2006
Last updated
07/21/2022
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