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:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8322

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X N/A South Dakota

Profile Details

NPI number 1639174568
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 Jun 16th, 2005
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639174568 NPPES
South Dakota MEDICAID 5307010
South Dakota MEDICAID 5307012
South Dakota Other 4998666
South Dakota Other 00-00592
South Dakota Other CR0890

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