Organization
AVERA MCKENNAN
Active
Other names
AVERA MCKENNAN CAMPUS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
1325 S CLIFF AVE, SUITE CP, SIOUX FALLS, SD 57105-1008
(605) 322-8326
(605) 322-8330
Mailing address
1325 S CLIFF AVE, SUITE CP, SIOUX FALLS, SD 57105-1008
(605) 322-8326
(605) 322-8330
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
1000452
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750442901
—
IA
05
—
1750442901
—
MN
01
—
4304010
OTHER ID NUMBER
—
05
—
8503150
—
SD
Enumeration date
12/12/2006
Last updated
10/06/2023
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