AVERA QUEEN OF PEACE NPI 1801193453

NPI Information

NPI: 1801193453
Provider Name: AVERA QUEEN OF PEACE

Doing Business As: AVERA GRASSLAND DIAGNOSTICS

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301
Phone: (605) 995-7000
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AVERA QUEEN OF PEACE is a radiology clinic center in Mitchell, SD. AVERA QUEEN OF PEACE NPI is 1801193453. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Grassland Diagnostics.

The provider's business location address is:

1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301-205
Phone: (605) 995-7000

The provider's authorized official is Douglas Ekeren .
The authorized official title is President/ceo and has the following contact phone number (605) 668-8322.

The CLIA number assigned to this NPI record is 43D0407438 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/17/2011 and was last updated on 8/20/2020.

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	261QR0200X	Clinic/Center	Radiology			Yes

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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