Avera Specialty Pharmacy

LBN: Avera Mckennan
Avera Specialty Pharmacy is an health care organization with primary practice located at 500 E 56Th St N Ste 3150 , Sioux Falls SD 57104-0408. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Specialty Pharmacy is the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-8300, or through Place, Ronald Jospeh via phone (605) 322-7903.

Contact Information

Primary practice address
500 E 56Th St N Ste 3150 Sioux Falls SD 57104-0408
Phone: (605) 322-8300
Fax: (605) 322-8361
Website:
Map and Directions
Authorized official contact:
Name: Place, Ronald Jospeh Doctor of Medicine (MD)
Phone: (605) 322-7903

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 261725 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X 3254 Iowa
Suppliers / Specialty Pharmacy 3336S0011X 30747 Texas
Suppliers / Specialty Pharmacy 3336S0011X Y006781 Arizona
Suppliers / Specialty Pharmacy 3336S0011X 100-1867 South Dakota
Suppliers / Specialty Pharmacy 3336S0011X 637 Nebraska
Suppliers / Specialty Pharmacy 3336S0011X PHAR396 North Dakota

Profile Details

NPI number 1346266202
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Specialty Pharmacy
Authorized official Place, Ronald Jospeh Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2006
Last updated Sep 7th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346266202 NPPES
South Dakota MEDICAID 8504220
South Dakota MEDICAID 1346266202
South Dakota MEDICAID 1346266202
South Dakota MEDICAID 100261606-00
South Dakota Other 2094315

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