Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Flandreau
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE N NORTON (SENIOR VICE PRESIDENT OF FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
212 NORTH PRAIRIE STREET, FLANDREAU, SD 57028-1296
(605) 997-2471
(605) 997-2418
Mailing address
212 NORTH PRAIRIE STREET, FLANDREAU, SD 57028-1296
(605) 997-2471
(605) 997-2418
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0571919
—
IA
05
—
10025371500
—
NE
01
—
10025485500
RHC MEDICAID NE
NE
01
—
106366608
DEPARTMENT OF LABOR
SD
05
—
126277700
—
MN
01
—
4995978
BCBS OF SOUTH DAKOTA
SD
05
—
5340320
—
SD
01
—
659S2FL
BCBS OF MN
MN
05
—
80484900
—
WI
01
—
9216572
DAKOTACARE
SD
01
—
95027
HEALTHPARTNERS
SD
Enumeration date
02/01/2006
Last updated
02/16/2011
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