Avera Medical Group Salem
LBN: Avera Queen Of Peace
Avera Medical Group Salem is an health care organization with primary practice located at 741 S Hill St , Salem SD 57058-8761. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty.
Avera Queen Of Peace can be contacted via phone (605) 425-3038, or through Ekeren, Douglas via phone (605) 668-8322.
Contact Information
Primary practice address
741 S Hill St
Salem SD 57058-8761
Phone: (605) 425-3038
Fax: (605) 425-3039
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / Rural Health | 261QR1300X | NA | South Dakota |
Profile Details
NPI number | 1619201829 |
---|---|
LBN Legal business name | Avera Queen Of Peace |
DBA Doing business as | Avera Medical Group Salem |
Authorized official | Ekeren, Douglas |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Sep 22nd, 2009 |
Last updated | Aug 20th, 2020 - about 4 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619201829 | NPPES |
South Dakota | Other | S1639 | MEDICARE PART B |
South Dakota | Other | 00-00592 | MEDICARE PART B |
South Dakota | Other | 4991003 | MEDICARE PART B |
South Dakota | MEDICAID | 5307012 | MEDICARE PART B |
South Dakota | Other | CR0890 | MEDICARE PART B |
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