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SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC NPI 1033195912


NPI Information

NPI: 1033195912
Provider Name: SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC

Doing Business As: AVERA ENDOSCOPY/SURGICAL CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
310 S PENNSYLVANIA ST
SUITE 201
ABERDEEN, SD
ZIP 57401
Phone: (605) 229-1367
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SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC is an ambulatory surgical clinic center in Aberdeen, SD. SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC NPI is 1033195912. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Endoscopy/surgical Center.

The provider's business location address is:

310 S PENNSYLVANIA ST
SUITE 201
ABERDEEN, SD
ZIP 57401-553
Phone: (605) 229-1367
Fax: (605) 229-1002

The provider's authorized official is Bradley W Olson .
The authorized official title is General Manager and has the following contact phone number (605) 229-1367.

The enumeration date for this NPI number is 12/21/2005 and was last updated on 4/14/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical48090SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18063MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
25490320MEDICAIDSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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