Avera Medical Group Orthopedics & Sports Medicine

LBN: Avera Queen Of Peace
Avera Medical Group Orthopedics & Sports Medicine is an health care organization with primary practice located at 625 N Foster St Ste 200 , Mitchell SD 57301-2968. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Avera Queen Of Peace can be contacted via phone (605) 995-3463, or through Ekeren, Douglas via phone (605) 668-8322.

Contact Information

Primary practice address
625 N Foster St Ste 200 Mitchell SD 57301-2968
Phone: (605) 995-3463
Fax: (605) 996-0718
Website:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8322

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1699972422
LBN Legal business name Avera Queen Of Peace
DBA Doing business as Avera Medical Group Orthopedics & Sports Medicine
Authorized official Ekeren, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Jun 27th, 2007
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 1699972422 NPPES
South Dakota MEDICAID 0100130

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