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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