Avera Grassland Pharmacy

LBN: Avera Queen Of Peace
Avera Grassland Pharmacy is an health care organization with primary practice located at 1900 Grassland Dr Ste 101, Mitchell SD 57301. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Avera Queen Of Peace can be contacted via phone (605) 995-5670, or through Ekeren, Douglas via phone (605) 668-8321.

Contact Information

Primary practice address
1900 Grassland Dr Ste 101 Mitchell SD 57301
Phone: (605) 995-5670
Fax: (605) 996-6805
Website:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8321

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 100-2030 South Dakota

Profile Details

NPI number 1710359252
LBN Legal business name Avera Queen Of Peace
DBA Doing business as Avera Grassland Pharmacy
Authorized official Ekeren, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2015
Last updated Sep 14th, 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 1710359252 NPPES
Other 2154706 PK

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