AVERA MCKENNAN NPI 1164492906

NPI Information

NPI: 1164492906
Provider Name: AVERA MCKENNAN
Classification: Home Infusion - 251F00000X
Entity Type: Organization
:
Address: 4101 W MEMORY CIR STE 110
SIOUX FALLS, SD
ZIP 57107
Phone: (605) 322-8322

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NPI Details

AVERA MCKENNAN is a home infusion in Sioux Falls, SD. AVERA MCKENNAN NPI is 1164492906. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

4101 W MEMORY CIR STE 110
SIOUX FALLS, SD
ZIP 57107-504
Phone: (605) 322-8322
Fax: (605) 322-8317

The provider's authorized official is Ronald Joseph Place .
The authorized official title is President/ceo and has the following contact phone number (605) 322-7903.

The enumeration date for this NPI number is 1/24/2006 and was last updated on 7/23/2025.

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	332B00000X	Durable Medical Equipment & Medical Supplies		100-1663	SOUTH DAKOTA	No
2	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	100-1663	SOUTH DAKOTA	No
3	333600000X	Pharmacy		1001663	SOUTH DAKOTA	No
4	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	100-1663	SOUTH DAKOTA	No
5	3336S0011X	Pharmacy	Specialty Pharmacy	100-1663	SOUTH DAKOTA	No
6	251F00000X	Home Infusion		1001663	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
1	4304971	MEDICAID	IOWA
2	350516200	MEDICAID	MINNESOTA
3	9166500	MEDICAID	SOUTH DAKOTA
4	8504010	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: 11/21/2025

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