AVERA MCKENNAN (NPI# 1346266202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346266202 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Practice Address |
1301 S Cliff Ave Suite 200 Sioux Falls SD 57105-1005 |
| Mailing Address |
1301 S Cliff Ave Suite 200 Sioux Falls SD 57105 |
| Practice Telephone | 6053228360 |
| Practice Fax Number | 6053228361 |
| Mailing Telephone | 6053228360 |
| Mailing Fax Number | 6053228361 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-07-06 |
| Authorized Official Name | MR. DARREL MUTCHLER (DIR OF AVERA RETAIL PHARMACY) |
| Authorized Official Telephone | 6053228331 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PH29728 | FL | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
3254 | IA | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
30747 | TX | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Y006781 | AZ | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
100-1867 | SD | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
637 | NE | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PHAR396 | ND | Suppliers |
| Y | 333600000X | Pharmacy | 261725 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 100261606-00 | 05 | |
| MN | 1346266202 | 05 | |
| IA | 1346266202 | 05 | |
| PK | 2094315 | 01 | |
| SD | 8504220 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154979805 | Avera Mckennan | Substance Abuse Rehabilitation Facility | 6140 S Curae Lane, Sioux Falls, SD 57108-3047 | 2019-08-27 |
| 1205311628 | Avera Mckennan | Pharmacy | 6100 S Louise Ave Ste 1100, Sioux Falls, SD 57108-6021 | 2018-10-02 |
| 1316463219 | Avera Mckennan | Pharmacy | 1200 S. 7th Avenue, Suite 101, Sioux Falls, SD 57105 | 2017-08-22 |
| 1851848444 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 2100 S Marion Road, Ste 125, Sioux Falls, SD 57106-3645 | 2016-09-01 |
| 1295187417 | Avera Mckennan | Psychiatry & Neurology | 6709 S. Minnesota Ave., Ste. 103, Sioux Falls, SD 57108-2593 | 2016-07-12 |
| 1669871000 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 3820 N Potsdam Ave Ste 2, Sioux Falls, SD 57104-7057 | 2014-08-21 |
| 1922413806 | Avera Mckennan | Clinic/Center | 400 2nd Ave, Brookings, SD 57006 | 2014-06-30 |
| 1629499132 | Avera Mckennan | Occupational Therapist | 1601 W 44th Pl, Sioux Falls, SD 57105-6376 | 2013-12-31 |
| 1700146396 | Avera Mckennan | Clinic/Center | 1035 South Highline Pl, Ste #4, Sioux Falls, SD 57110 | 2012-05-17 |
| 1467711739 | Avera Mckennan | Pharmacy | 1301 S Cliff Ave Ste 225, Sioux Falls, SD 57105-1068 | 2012-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | AVERA MCKENNAN | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Iowa Business Entities | AVERA MCKENNAN | 1325 S. Cliff St., Sioux Falls, SD 57105 |
| System for Award Management (SAM) Entities | AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S Cliff Ave, Sioux Falls, SD 57105-1007 |
| Street Address |
1301 S CLIFF AVE SUITE 200 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194723924 | Henry Travers | Pathology | 1301 S Cliff Ave, Suite 700, Sioux Falls, SD 57105-1019 | 2005-07-14 |
| 1245864693 | Rachel Wolkow | Nurse Practitioner | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2020-02-25 |
| 1942723838 | Holly M Bonnichsen | Audiologist | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2017-07-21 |
| 1194276956 | Nicole Rae Nelson | Nurse Practitioner | 1301 S Cliff Ave, #610, Sioux Falls, SD 57105-1005 | 2016-10-17 |
| 1780134023 | Andrew Jacob Murtha | Nurse Practitioner | 1301 S Cliff Ave, Sioux Falls, SD 57105-1005 | 2016-10-11 |
| 1003269176 | Paul Stamp | Nurse Practitioner | 1301 S Cliff Ave, Suite 610, Sioux Falls, SD 57105-1005 | 2016-07-13 |
| 1639535198 | Avera Mckennan | Durable Medical Equipment & Medical Supplies | 1301 S Cliff Ave, Ste. 220, Sioux Falls, SD 57105-1005 | 2016-01-13 |
| 1801274626 | Melissa Mathiowetz | Physical Therapist | 1301 S Cliff Ave, Suite 402, Sioux Falls, SD 57105-1005 | 2015-05-13 |
| 1831590447 | Rebecca Gayle Hruby | Nurse Practitioner | 1301 S Cliff Ave, Suite 506, Sioux Falls, SD 57105-1005 | 2014-09-15 |
| 1427463371 | Elizabeth Cecilia Stauss | Nurse Practitioner | 1301 S Cliff Ave, Plaza 2 Suite 401, Sioux Falls, SD 57105-1005 | 2014-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013525864 | Spring Meds Inc | Pharmacy | 2810 W 3rd St Ste 3, Sioux Falls, SD 57104-2598 | 2020-07-17 |
| 1205311628 | Avera Mckennan | Pharmacy | 6100 S Louise Ave Ste 1100, Sioux Falls, SD 57108-6021 | 2018-10-02 |
| 1962787440 | Avera Mckennan | Pharmacy | 4400 W 69th St Ste 300, Sioux Falls, SD 57108-8170 | 2011-10-17 |
| 1073692745 | Ameripharm Inc | Pharmacy | 2503 E 54th St N, Sioux Falls, SD 57104-5563 | 2006-11-03 |
| 1578653572 | Lewis Drugs, Inc. | Pharmacy | 4409 E 26th St, Sioux Falls, SD 57103-4136 | 2006-10-13 |
| 1174612790 | Lewis Drugs, Inc. | Pharmacy | 5500 W 41st St, Sioux Falls, SD 57106-1009 | 2006-10-12 |
| 1841389467 | Lewis Drugs, Inc. | Pharmacy | 2901 S Minnesota Ave, Sioux Falls, SD 57105-6402 | 2006-10-12 |
| 1699878710 | Prescription Shop Inc | Pharmacy | 1200 S 7th St Ave, Ste 100, Sioux Falls, SD 57105 | 2006-09-06 |
| 1225030448 | Tel-drug Inc | Pharmacy | 4901 N 4th Ave, Sioux Falls, SD 57104-0444 | 2005-06-01 |
| 1437512142 | K Mart 7318 | Pharmacy | 3020 W 12th St, Sioux Falls, SD 57104-3704 | 2016-03-30 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
Please comment or provide details below to improve the information on AVERA MCKENNAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.