Organization
AVERA QUEEN OF PEACE
Active
Parent organization
AVERA QUEEN OF PEACE
Other names
Avera Weskota Memorial Medical Center Swing Bed Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVERA QUEEN OF PEACE
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
604 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2134
(605) 539-1021
(605) 539-4580
Mailing address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2000
(605) 995-2441
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
48209
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159082
—
SD
Enumeration date
06/17/2005
Last updated
08/20/2020
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