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:
Authorized official contact:
Name: Place, Ronald Jospeh Doctor of Medicine (MD)
Phone: (605) 322-7903
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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