Organization
AVERA QUEEN OF PEACE
Active
Other names
Avera Medical Group Corsica
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
265 MAIN STREET, CORSICA, SD 57328
(605) 946-5411
(605) 946-5206
Mailing address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2000
(605) 995-2441
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
N/A
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-00435
MEDICA
SD
01
—
0000018
WELLMARK
SD
05
—
5306742
—
SD
05
—
5306743
—
SD
01
—
A-87545
MULTIPLAN
SD
01
—
CR0890
MEDICARE RR
SD
Enumeration date
06/23/2005
Last updated
08/20/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us