Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Surgery Pierre
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (VP FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
100 MAC LN, PIERRE, SD 57501-3391
(605) 224-5901
(605) 945-3244
Mailing address
100 MAC LN, PIERRE, SD 57501-3391
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11146
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO6835
RR MEDICARE
SD
Enumeration date
12/12/2008
Last updated
04/29/2011
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