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AVERA MCKENNAN NPI 1407141344


NPI Information

NPI: 1407141344
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA DERMATOLOGY PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
6701 S MINNESOTA AVE
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 322-7695
Get Directions

AVERA MCKENNAN is a community/retail pharmacy pharmacy in Sioux Falls, SD. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. AVERA MCKENNAN NPI is 1407141344. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Dermatology Pharmacy.

The provider's business location address is:

6701 S MINNESOTA AVE
SIOUX FALLS, SD
ZIP 57108-591
Phone: (605) 322-7695
Fax: (605) 322-7696

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 6/17/2011 and was last updated on 10/4/2023.


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
1333600000XPharmacy265029MINNESOTANo
23336C0002XPharmacyClinic Pharmacy100-1965SOUTH DAKOTANo
33336S0011XPharmacySpecialty PharmacyNo
43336C0003XPharmacyCommunity/Retail Pharmacy4651IOWAYes

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
11407141344MEDICAIDSOUTH DAKOTA
22130603OTHERPK

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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