AVERA ST LUKES NPI 1912011867

NPI Information

NPI: 1912011867
Provider Name: AVERA ST LUKES
Classification: Durable Medical Equipment & Medical Supplies - 332BX2000X
Entity Type: Organization

Specialization: Oxygen Equipment & Supplies

Address:
305 S STATE ST
ABERDEEN, SD
ZIP 57401
Phone: (605) 622-5000
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AVERA ST LUKES is an oxygen equipment and supplies durable medical equipment medical supplies in Aberdeen, SD. AVERA ST LUKES NPI is 1912011867. The provider is registered as an organization entity type.

The provider's business location address is:

305 S STATE ST
ABERDEEN, SD
ZIP 57401-527
Phone: (605) 622-5000
Fax: (605) 622-5255

The provider's authorized official is Ronald L Jacobson .
The authorized official title is Ceo and has the following contact phone number (605) 622-5125.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 10/22/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	335E00000X	Prosthetic/Orthotic Supplier		10525	SOUTH DAKOTA	No
2	3336I0012X	Pharmacy	Institutional Pharmacy	10525	SOUTH DAKOTA	No
3	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	10525	SOUTH DAKOTA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0588460001	MEDICARE NSC	SOUTH DAKOTA
2	9163240	MEDICAID	SOUTH 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: 4/28/2024

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