Organization
AVERA MCKENNAN
Active
Other names
Avera Gregory Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (CEO/PRESIDENT)
(605) 322-7903
Entity
Organization
Contact information
Practice address
110 S LOGAN AVE, GREGORY, SD 57533-1614
(605) 835-8394
Mailing address
PO BOX 408, 400 PARK AVE., GREGORY, SD 57533-0408
(605) 835-8394
(605) 835-9422
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
282NC0060X
Critical Access Hospital
54875
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5500350
—
SD
Enumeration date
09/12/2006
Last updated
10/04/2023
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