Organization
AVERA TYLER
Active
Parent organization
AVERA MARSHALL
Other names
Avera Tyler Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVERA MARSHALL
Authorized official
DEBBIE STREIER (CEO)
(507) 537-9160
Entity
Organization
Contact information
Practice address
240 WILLOW STREET, TYLER, MN 56178
(507) 247-5521
(507) 247-2325
Mailing address
240 WILLOW ST, TYLER, MN 56178-1166
(507) 247-5521
(507) 247-2325
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
380347
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1889EAL
BLUE CROSS
MN
05
—
599245100
—
MN
Enumeration date
12/22/2006
Last updated
12/02/2022
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