AVERA MCKENNAN NPI 1871527507

NPI Information

AVERA MCKENNAN is a primary care clinic center in Larchwood, IA. AVERA MCKENNAN NPI is 1871527507. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Larchwood.

The provider's business location address is:

916 HOLDER ST
LARCHWOOD, IA
ZIP 51241-008
Phone: (712) 477-2185
Fax: (712) 477-2186

The provider's authorized official is Julie N Norton .
The authorized official title is Sr Vice President Of Finance and has the following contact phone number (605) 322-6375.

The CLIA number assigned to this NPI record is 16D0901662 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 5/16/2012.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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