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
1508 4TH ST NE, WATERTOWN, SD 57201-6824
(605) 882-3511
(605) 882-3062
Mailing address
PO BOX 5045, SIOUX FALLS, SD 57117-5045
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
14003EST001
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9161926
—
SD
Enumeration date
11/28/2006
Last updated
06/25/2026
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