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Contact Information

AVERA MCKENNAN
210 KASAN AVE
VOLGA, SD57071
 Phone: 605-627-5701
 Fax: 605-627-5990
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI # 1063432573
LBN Legal business name AVERA MCKENNAN
Authorized official JULIE NORTON - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/20/2006
Last updated 03/11/2011 - About 15 years ago
Identifiers
SD License # 84
SD Medicaid 7300750
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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