Organization
AVERA MCKENNAN
Active
Other names
Avera Flandreau Hospital Swingbed
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
214 N PRAIRIE ST, FLANDREAU, SD 57028-1243
(605) 997-2433
(605) 997-3611
Mailing address
PO BOX 5045 ATTN PRVENROLMT PALM PLACE BLDG, SIOUX FALLS, SD 57117-5045
(605) 322-6428
(605) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
10540
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159732
—
SD
01
—
8Z310
SD BLUE CROSS SWGBD PROV#
SD
Enumeration date
08/23/2006
Last updated
10/13/2023
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