Avera Medical Group Corsica
LBN: Avera Queen Of Peace
Avera Medical Group Corsica is an health care organization with primary practice located at 265 Main Street , Corsica SD 57328. 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) 946-5411, or through Ekeren, Douglas via phone (605) 668-8322.
Contact Information
Primary practice address
265 Main Street
Corsica SD 57328
Phone: (605) 946-5411
Fax: (605) 946-5206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X | N/A | South Dakota |
Profile Details
| NPI number | 1932105046 |
|---|---|
| LBN Legal business name | Avera Queen Of Peace |
| DBA Doing business as | Avera Medical Group Corsica |
| Authorized official | Ekeren, Douglas |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 23rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932105046 | NPPES |
| South Dakota | Other | CR0890 | MEDICARE RR |
| South Dakota | MEDICAID | 5306742 | MEDICARE RR |
| South Dakota | MEDICAID | 5306743 | MEDICARE RR |
| South Dakota | Other | 0000018 | MEDICARE RR |
| South Dakota | Other | A-87545 | MEDICARE RR |
| South Dakota | Other | 00-00435 | MEDICARE RR |
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