AVERA MCKENNAN (NPI# 1669871000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669871000 |
| Entity Type | Organization |
| Organization Name | AVERA MCKENNAN |
| Other Organization Name | AVERA LONG TERM CARE PHARMACY |
| Practice Address |
3820 N Potsdam Ave Ste 2 Sioux Falls SD 57104-7057 |
| Practice Telephone | 6053221450 |
| Practice Fax Number | 6053221451 |
| Mailing Telephone | 6053221450 |
| Mailing Fax Number | 6053221451 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-09-29 |
| Authorized Official Name | JULIE NORTON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6053227818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
100-1994 | SD | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2147429 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Long Term Care Pharmacy | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1346512266 | Avera Mckennan | Family Medicine | 1035 South Highline Place, Sioux Falls, SD 57110-1000 | 2012-02-08 |
| 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 |
3820 N POTSDAM AVE STE 2 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-7057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730729484 | Lewis Family Drug, LLC | Pharmacy | 2700 W 12th St Ste 100, Sioux Falls, SD 57104-3701 | 2020-01-10 |
| 1528157146 | Lewis Drugs, Inc. | Pharmacy | 1301 E 10th St, Suite 100, Sioux Falls, SD 57103-1780 | 2006-10-12 |
| 1942312392 | Omnicare Pharmacy and Supply Services LLC | Pharmacy | 709 N Kiwanis Ave, Sioux Falls, SD 57104-1825 | 2006-08-31 |
| 1396781845 | Complete Home Care Inc | Pharmacy | 1104 W Russell St, Sioux Falls, SD 57104-1323 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780149864 | Lewis Family Drug, LLC | Pharmacy | 925 Sd Hwy 10, Sisseton, SD 57262 | 2019-02-04 |
| 1215491980 | Lewis Family Drug, LLC | Pharmacy | 119 6th Ave Sw, Aberdeen, SD 57401-5947 | 2019-01-28 |
| 1902253214 | Wyodak Pharmacies Inc | Pharmacy | 145 Glendale Dr, Lead, SD 57754 | 2016-05-17 |
| 1740635325 | Lewis Family Drug, LLC | Pharmacy | 404 3rd Ave S, Clear Lake, SD 57226 | 2016-05-02 |
| 1891009783 | Winner Health Mart Pharmacy Inc | Pharmacy | 702 W 2nd St, Winner, SD 57580-1113 | 2010-08-03 |
| 1518288026 | Eureka Pharmacy & Gift Shoppe Inc | Pharmacy | 511 5th Avenue, Ipswich, SD 57451 | 2010-06-18 |
| 1811141815 | Main Street Pharmacy I Corp | Pharmacy | 389 S Main St, Freeman, SD 57029-2337 | 2008-11-05 |
| 1366514036 | Coborns Inc | Pharmacy | 2150 Dakota Ave S, Huron, SD 57350-4311 | 2006-11-15 |
| 1104931146 | R Thomas Bartholomew | Pharmacy | 118 8th Ave S, Faulkton, SD 57438-2115 | 2006-08-20 |
| 1922113968 | Bhp Inc | Pharmacy | 2210 Jackson Blvd, Rapid City, SD 57702-3419 | 2006-08-20 |
| Find all providers with the same taxonomy | ||||
| City | SIOUX FALLS |
| Zip Code | 57104 |
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.