Organization Name: | AVERA ST MARYS |
NPI Number: | 1144238619 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEOFFREY MICHAEL DURST (VP FINANCE) |
Mailing Address: | 801 E Sioux Ave Pierre |
State: | SD US |
Postal Code: | 575013323 |
Phone Number: | 6052243100 |
Fax Number: | |
NPI Enumeration Date: | 08/03/2006 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 432305 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |