Avera Compounding Pharmacy
LBN: Avera Mckennan
Avera Compounding Pharmacy is an health care organization with primary practice located at 911 E 20Th St Ste 201 , Sioux Falls SD 57105-1044. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty.
Avera Mckennan can be contacted via phone (605) 322-3940, or through Place, Ronald Joseph via phone (605) 322-7903.
Contact Information
Primary practice address
911 E 20Th St Ste 201
Sioux Falls SD 57105-1044
Phone: (605) 322-3940
Fax: (605) 322-3941
Website:
Authorized official contact:
Name: Place, Ronald Joseph Doctor of Medicine (MD)
Phone: (605) 322-7903
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | PH29727 | Florida |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 4140 | Iowa |
| Suppliers / Compounding Pharmacy | 3336C0004X | 1001973 | South Dakota |
| Suppliers / Compounding Pharmacy | 3336C0004X | 263952 | Minnesota |
| Suppliers / Compounding Pharmacy | 3336C0004X | 714 | Nebraska |
| Suppliers / Compounding Pharmacy | 3336C0004X | Y006782 | Arizona |
Profile Details
| NPI number | 1467711739 |
|---|---|
| LBN Legal business name | Avera Mckennan |
| DBA Doing business as | Avera Compounding Pharmacy |
| Authorized official | Place, Ronald Joseph Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 8th, 2012 |
| Last updated | Oct 4th, 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 | 1467711739 | NPPES |
| Other | 2134952 | PK |
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