AVERA ST LUKES NPI 1174548937

NPI Information

  • NPI: 1174548937
  • Provider Name: AVERA ST LUKES
  • Classification: Technician, Pathology - 246R00000X
  • Entity Type: Organization
  • :
  • Address: 1400 10TH AVE W
    MOBRIDGE, SD
    ZIP 57601
  • Phone: (605) 845-7292

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NPI Details

AVERA ST LUKES is a technician pathology in Mobridge, SD. The provider is an individual with knowledge of specific techniques and instruments who performs all of the routine tests in a medical laboratory and who has the ability to discriminate between similar factors that directly affect procedures and results. AVERA ST LUKES NPI is 1174548937. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1400 10TH AVE W
MOBRIDGE, SD
ZIP 57601-246
Phone: (605) 845-7292
Fax: (605) 845-7812

The provider's authorized official is Ron Jacobson .
The authorized official title is President and has the following contact phone number (605) 622-5502.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 9/11/2025.

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
12085R0202XRadiologyDiagnostic RadiologyNo
2246R00000XTechnician, PathologyYes

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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