Avera Home Medical Equipment, LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Watertown, SD

NPI 1144396102 · NPPES record last updated Jun 25, 2026

Key facts

NPI
1144396102
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
14003EST001 (SD)
Legal business name
AVERA HOME MEDICAL EQUIPMENT, LLC
Practice address
1508 4TH St NE
Watertown, SD 57201-6824
Phone
(605) 882-3511
Fax
(605) 882-3062
NPI assigned
Nov 28, 2006
Organization subpart
No

Authorized official

Name
Sandra D Dieleman
Title
President/Ceo
Phone
(605) 322-1872

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 6

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Avera Home Medical Equipment LLC
1508 - 4TH St NE, Watertown, SD 57201-6824 · (605) 882-3511
Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Insulin Infusion Pu… Does not accept assignment
Participating since Dec 27, 2002

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930042949 SD DME Supplier - Medical Supply Company
DME Supplier - Medical Supply Company With Respiratory Therapist
DME Supplier - Oxygen & Equipment
7618182205 Practice locations: Watertown, SD

National Provider Directory

Tax ID family
Avera Home Medical Equipment LLC (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 14003EST001 SD Yes

Addresses

Primary practice location

1508 4TH St NE
Watertown, SD 57201-6824

Mailing address

PO Box 5045
Sioux Falls, SD 57117-5045
Phone (605) 322-1872

Other identifiers

IdentifierTypeStateIssuer
9161926MedicaidSD

Other providers in Watertown, SD

All providers in Watertown, SD · Durable Medical Equipment & Medical Supplies in South Dakota

Sources for this page

Verify at the official NPI Registry.