Organization
AVERA HOME MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA DIELEMAN (PRESIDENT/CEO)
(605) 322-3984
Entity
Organization
Contact information
Practice address
115 N 6TH ST, ESTHERVILLE, IA 51334-2228
(712) 362-3568
(712) 362-3570
Mailing address
800 E 21ST ST, PO BOX 5045, SIOUX FALLS, SD 57105-1016
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
132004906
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0456632
—
IA
05
—
956635000
—
MN
Enumeration date
11/28/2006
Last updated
09/30/2024
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