Avera Breast Center

LBN: Avera Mckennan
Avera Breast Center is an health care organization with primary practice located at 1000 E 23Rd St Suite 330, Sioux Falls SD 57105-2113. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-7465, or through Flicek, David via phone (605) 322-7916.

Contact Information

Primary practice address
1000 E 23Rd St Suite 330 Sioux Falls SD 57105-2113
Phone: (605) 322-7465
Fax: (605) 322-1789
Website:
Map and Directions
Authorized official contact:
Name: Flicek, David
Phone: (605) 322-7916

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 10563 South Dakota

Profile Details

NPI number 1467695767
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Breast Center
Authorized official Flicek, David
Entity Organization
Organization subpart 1 No
Enumeration date Apr 16th, 2009
Last updated Jan 8th, 2021 - about 3 years ago

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 1467695767 NPPES
South Dakota MEDICAID 7290280
South Dakota MEDICAID 10025807100
South Dakota Other 9286132
South Dakota MEDICAID 1467695767
South Dakota MEDICAID 1467695767

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