Organization
AVERA ST MARYS
Active
Other names
Avera St Marys Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JAMES WAGNER (CFO)
(605) 224-3127
Entity
Organization
Contact information
Practice address
801 E SIOUX AVE, PIERRE, SD 57501
(605) 224-3100
(605) 224-8339
Mailing address
801 E SIOUX AVE, PIERRE, SD 57501
(605) 224-3100
(605) 224-8339
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
437046
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0170030
—
SD
01
—
87046
BLUE CROSS PROVIDER #
SD
Enumeration date
08/04/2006
Last updated
07/07/2014
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