Avera McKennan

Organization Active NPI Ambulatory Surgical Clinic/Center · Pierre, SD

NPI 1083859532 · NPPES record last updated Apr 29, 2011

Key facts

NPI
1083859532
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
License
11146 (SD)
Legal business name
AVERA MCKENNAN
Practice address
100 Mac LN
Pierre, SD 57501-3391
Phone
(605) 224-5901
Fax
(605) 945-3244
NPI assigned
Dec 12, 2008
Organization subpart
No

Authorized official

Name
Julie N Norton
Title
VP Finance
Phone
(605) 322-6375

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 11146 SD Yes

Addresses

Primary practice location

100 Mac LN
Pierre, SD 57501-3391

Mailing address

100 Mac LN
Pierre, SD 57501-3391

Other identifiers

IdentifierTypeStateIssuer
DO6835OtherSDRR MEDICARE

Other names

  • Avera Medical Group Surgery Pierre Doing business as

Other providers in Pierre, SD

All providers in Pierre, SD · Ambulatory Surgical Clinic/Center in South Dakota

Sources for this page

Verify at the official NPI Registry.