Organization
AVERA HOME MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA D DIELEMAN (MEMBER REPRESENTATIVE)
(605) 322-3984
Entity
Organization
Contact information
Practice address
1521 CARLSON ST STE A, MARSHALL, MN 56258-2626
(507) 537-7070
(507) 537-7074
Mailing address
2400 S MINNESOTA AVE, PO BOX 5045, SIOUX FALLS, SD 57105-3761
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
8491260
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118605000
—
MN
Enumeration date
08/03/2006
Last updated
11/13/2023
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