Avera Medical Group Worthington

LBN: Avera Mckennan
Avera Medical Group Worthington is an health care organization with primary practice located at 1216 Ryans Rd , Worthington MN 56187-1722. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Avera Mckennan can be contacted via phone (507) 372-2921, or through Van Grouw, Kelli via phone (507) 372-2921.

Contact Information

Primary practice address
1216 Ryans Rd Worthington MN 56187-1722
Phone: (507) 372-2921
Fax: (507) 372-5789
Website:
Map and Directions
Authorized official contact:
Name: Van Grouw, Kelli
Phone: (507) 372-2921

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1700062213
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Medical Group Worthington
Authorized official Van Grouw, Kelli
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 15th, 2008
Last updated Apr 1st, 2013 - about 12 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 1700062213 NPPES
Minnesota Other 690009299 RAILROAD MEDICARE
Minnesota Other 48941WO RAILROAD MEDICARE
Minnesota MEDICAID 951015000 RAILROAD MEDICARE

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