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:
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 NA South Dakota

Profile Details

NPI number 1952635492
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 Oct 1st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952635492 NPPES
South Dakota Other 4991000 WELLMARK
South Dakota MEDICAID 5306743 WELLMARK
South Dakota Other 00-00435 WELLMARK

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