Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Gregory
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WILLIAM FLICEK (PRESIDENT/CEO)
(605) 322-7915
Entity
Organization
Contact information
Practice address
110 S LOGAN AVE STE A, GREGORY, SD 57533-1614
(605) 835-9611
(605) 835-8033
Mailing address
110 S LOGAN AVE STE A, GREGORY, SD 57533-1614
(605) 835-9611
(605) 835-8033
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000028
WELLMARK BC/BS
SD
05
—
46011474312
—
NE
Enumeration date
06/12/2006
Last updated
11/17/2025
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