Avera Queen of Peace

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

100-1023 Issued in SD

Legal business name

AVERA QUEEN OF PEACE

Doing business as

Avera Queen of Peace Home Medical Equipment

Practice address

525 N Foster St
Mitchell, SD 57301-2966

Phone

(605) 995-2460

Fax

(605) 995-5672

NPI assigned

Jun 17, 2005

Last updated

Aug 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Ekeren

Title

President/Ceo

Phone

(605) 668-8322

Specialties & licenses 2

Addresses

Other names 1

• AVERA QUEEN OF PEACE HOME MEDICAL EQUIPMENT Doing business as

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1851396550",
    "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": "605-995-5672"
        },
        {
            "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": "605-995-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA QUEEN OF PEACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "EKEREN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8322"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SD",
            "license": "100-1023",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SD",
            "license": "100-1023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVERA QUEEN OF PEACE HOME MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AVERA QUEEN OF PEACE HOME MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Mitchell, SD
• Providers in Mitchell, SD by specialty
• Durable Medical Equipment & Medical Supplies in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.