Avera Breast Center Mobile

LBN: Avera Mckennan
Avera Breast Center Mobile 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 / Radiology, Mobile Mammography, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-7465, or through Place, Ronald Joseph via phone (605) 322-7903.

Contact Information

Primary practice address
1000 E 23Rd St Suite 330 Sioux Falls SD 57105-2113
Phone: (605) 322-7465
Fax:
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 / Radiology, Mobile Mammography 261QR0207X 10563 South Dakota

Profile Details

NPI number 1588997365
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Breast Center Mobile
Authorized official Place, Ronald Joseph Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 11th, 2009
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588997365 NPPES
South Dakota Other 1588997365 WELLMARK BCBS SD
South Dakota MEDICAID 7290300 WELLMARK BCBS SD
South Dakota Other 9290118 WELLMARK BCBS SD

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