Organization
AVERA QUEEN OF PEACE
Active
Other names
Avera Queen of Peace Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2000
(605) 995-2441
Mailing address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2000
(605) 995-2441
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
282NR1301X
Rural Acute Care Hospital
Primary
10552
SD
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100130
—
SD
01
—
5500130
MEDICAID OUTPATIENT
SD
01
—
CR0890
RR MEDICARE
SD
Enumeration date
05/31/2005
Last updated
08/20/2020
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