Avera Dialysis Wagner

LBN: Avera Mckennan
Avera Dialysis Wagner is an health care organization with primary practice located at 310 W Sd Highway 46 , Wagner SD 57380-9304. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 384-4980, or through Place, Ronald Joseph via phone (605) 322-7903.

Contact Information

Primary practice address
310 W Sd Highway 46 Wagner SD 57380-9304
Phone: (605) 384-4980
Fax: (605) 384-4990
Website:
Map and Directions
Authorized official contact:
Name: Place, Ronald Joseph Doctor of Medicine (MD)
Phone: (605) 322-7903

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 10563 South Dakota

Profile Details

NPI number 1538527106
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Dialysis Wagner
Authorized official Place, Ronald Joseph Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 10th, 2016
Last updated Oct 4th, 2023 - about 2 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 1538527106 NPPES
South Dakota Other 1538527106 WELLMARK BCBS

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