Organization
AVERA MCKENNAN
Active
Other names
Avera Gregory Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE NORTON (VP/CFO)
(605) 322-6375
Entity
Organization
Contact information
Practice address
400 PARK AVE, GREGORY, SD 57533-1302
(605) 835-8394
(605) 835-9422
Mailing address
PO BOX 5045, ATTN: P.F.S. PROV ENROLLMENT, SIOUX FALLS, SD 57117-5045
(605) 322-6400
(605) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171450
—
SD
05
—
9550490
—
SD
05
—
9556080
—
SD
Enumeration date
09/12/2006
Last updated
04/25/2012
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