Avera St Lukes Pharmacy

LBN: Avera St Lukes
Avera St Lukes Pharmacy is an health care organization with primary practice located at 305 S State St , Aberdeen SD 57401-4527. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Institutional Pharmacy is the primary health care specialty. Avera St Lukes can be contacted via phone (605) 622-5545, or through Jacobson, Ron via phone (605) 627-5625.

Contact Information

Primary practice address
305 S State St Aberdeen SD 57401-4527
Phone: (605) 622-5545
Fax: (605) 622-5019
Website:
Map and Directions
Authorized official contact:
Name: Jacobson, Ron
Phone: (605) 627-5625

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X 1000486 South Dakota
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1386738102
LBN Legal business name Avera St Lukes
DBA Doing business as Avera St Lukes Pharmacy
Authorized official Jacobson, Ron
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Sep 13th, 2007 - about 17 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 1386738102 NPPES
South Dakota MEDICAID 8502660
South Dakota Other 4300721

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