Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Colome
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (VICE PRESIDENT OF FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
308 MAIN ST, COLOME, SD 57528-0108
(605) 842-1186
Mailing address
PO BOX 108, 308 MAIN ST, COLOME, SD 57528-0108
(605) 842-1186
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000028
WELLMARK BC/BS
SD
Enumeration date
07/04/2006
Last updated
03/21/2011
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