Organization
AVERA QUEEN OF PEACE
Active
Other names
AVERA WESKOTA MEM MED CNTR
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8321
Entity
Organization
Contact information
Practice address
609 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2136
(605) 539-1201
Mailing address
609 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2136
(605) 539-1201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
2000994
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4353859
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/02/2006
Last updated
09/14/2020
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