Avera Grassland Diagnostics

LBN: Avera Queen Of Peace
Avera Grassland Diagnostics is an health care organization with primary practice located at 1900 Grassland Dr. , Mitchell SD 57301-6205. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Radiology, Laboratories / Clinical Medical Laboratory. Laboratories / Clinical Medical Laboratory is the primary health care specialty. Avera Queen Of Peace can be contacted via phone (605) 995-7000, or through Ekeren, Douglas via phone (605) 668-8322.

Contact Information

Primary practice address
1900 Grassland Dr. Mitchell SD 57301-6205
Phone: (605) 995-7000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8322

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X 63654 South Dakota
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1649577297
LBN Legal business name Avera Queen Of Peace
DBA Doing business as Avera Grassland Diagnostics
Authorized official Ekeren, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Feb 17th, 2011
Last updated Aug 20th, 2020 - about 6 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 1649577297 NPPES
South Dakota MEDICAID 1649577297

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