National Provider Identifier Database

AVERA MCKENNAN
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

AVERA MCKENNAN
1325 S CLIFF AVE
SUITE CP
SIOUX FALLS, SD57105-1008
Phone: 605-322-8326
Fax: 605-322-8330
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI Number 1750442901
Legal business name
LBN
AVERA MCKENNAN
Authorized official RONALD PLACE - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 12/12/2006
Last updated 10/06/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • SD License #: 1000452
  • IA Medicaid: 1750442901
  • MN Medicaid: 1750442901
  • SD Medicaid: 8503150
  • Other: 4304010 OTHER ID NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for AVERA MCKENNAN

There are currently no reviews for AVERA MCKENNAN


NPIdb - Home
v2.201