NPIMap

Organization Active NPI

Avera Home Medical Equipment, LLC

  • Durable Medical Equipment & Medical Supplies
  • Mitchell, SD
National Provider Identifier
1356799316
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
UNPD3R Issued in SD
Legal business name
AVERA HOME MEDICAL EQUIPMENT, LLC
Practice address
525 N Foster St
Mitchell, SD 57301-2966
Phone
(605) 995-2460
Fax
(605) 322-1892
NPI assigned
Jun 1, 2016
Last updated
Jun 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandra D Dieleman
Title
Member Representative
Phone
(605) 322-3984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X UNPD3R SD Primary

Addresses

Primary practice location

525 N Foster St
Mitchell, SD 57301-2966

Mailing address

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2460

National Provider Directory

National Provider Directory

Member of 6

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1356799316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N FOSTER ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012966",
            "telephone_number": "605-995-2460",
            "fax_number": "605-322-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N FOSTER ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573012966",
            "telephone_number": "605-995-2460",
            "fax_number": "605-322-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA HOME MEDICAL EQUIPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "DIELEMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER REPRESENTATIVE",
        "authorized_official_telephone_number": "605-322-3984"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SD",
            "license": "UNPD3R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.