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Contact Information

AVERA MCKENNAN
1200 S. 7TH AVENUE
SUITE 101
SIOUX FALLS, SD57105
 Phone: 605-336-1816
 Fax: 605-504-0201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI # 1316463219
LBN Legal business name AVERA MCKENNAN
Authorized official RONALD PLACE - (PRESIDENT/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/22/2017
Last updated 10/04/2023 - About 3 years ago
Identifiers
SD License # 100-2048
Other 4354813 NCPDP
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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