AVERA MCKENNAN NPI 1669871000

NPI Information

NPI: 1669871000
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA LONG TERM CARE PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 43D2193490

Address:
3820 N POTSDAM AVE STE 2
SIOUX FALLS, SD
ZIP 57104
Phone: (605) 322-1450
Get Directions

AVERA MCKENNAN is a long term care pharmacy pharmacy in Sioux Falls, SD. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. AVERA MCKENNAN NPI is 1669871000. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Long Term Care Pharmacy.

The provider's business location address is:

3820 N POTSDAM AVE STE 2
SIOUX FALLS, SD
ZIP 57104-057
Phone: (605) 322-1450
Fax: (605) 322-1451

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 CLIA number assigned to this NPI record is 43D2193490 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2014 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	333600000X	Pharmacy				No
3	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
4	3336C0004X	Pharmacy	Compounding Pharmacy			No
5	3336L0003X	Pharmacy	Long Term Care Pharmacy	100-1994	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	2147429	OTHER		PK

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

NPI Synchronization or Removal

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