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Contact Information

AVERA MCKENNAN
916 HOLDER ST
LARCHWOOD, IA51241-0008
 Phone: 712-477-2185
 Fax: 712-477-2186
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI # 1871527507
LBN Legal business name AVERA MCKENNAN
Authorized official JULIE NORTON - (SR VICE PRESIDENT OF FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 07/10/2006
Last updated 05/16/2012 - About 14 years ago
Identifiers
IA Medicaid 0425074
IA Medicaid 2900993
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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