Organization
WAGNER COMMUNITY MEMORIAL HOSPITAL AVERA
Active
Organization
WAGNER COMMUNITY MEMORIAL HOSPITAL AVERA
Active
Other names
Wagner Community Clinic Avera
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN SLABA (CEO)
(605) 384-3611
Entity
Organization
Contact information
Practice address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-3611
(605) 384-3232
Mailing address
PO BOX 280, 513 3RD ST SW, WAGNER, SD 57380-0280
(605) 384-3611
(605) 384-3232
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
43D0407563
SD
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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