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Organization

AVERA ST. MARY'S

Active
Parent organization
AVERA ST. MARY'S HOSPITAL CHILD ASSESSMENT CENTER
Other names
Avera St. Mary's Hospital
Organization subpart
Yes

Provider details

NPI number
Legal business name
AVERA ST. MARY'S HOSPITAL CHILD ASSESSMENT CENTER
Authorized official
MIKEL HOLLAND (CEO/PRESIDENT)
(605) 224-3144
Entity
Organization

Contact information

Practice address
801 E SIOUX AVE, PIERRE, SD 57501-3323
(605) 224-3100
(605) 224-8339
Mailing address
PO BOX 5045, CBO PALM PLACE PRV ENRLMT, SIOUX FALLS, SD 57117-5045
(605) 322-6428
(605) 224-8339

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5405080
SD
Enumeration date
05/16/2013
Last updated
07/15/2022
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