Organization
AVERA HOME MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA D DIELEMAN (MEMBER REPRESENTATIVE)
(605) 322-3984
Entity
Organization
Contact information
Practice address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2460
(605) 322-1892
Mailing address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2460
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
UNPD3R
SD
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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