| Organization Name: | AVERA HOME MEDICAL EQUIPMENT LLC |
| NPI Number: | 1790793933 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDRA D DIELEMAN (MEMBER REPRESENTATIVE) |
| Mailing Address: | 1104 E College Dr Marshall |
| State: | MN US |
| Postal Code: | 562584270 |
| Phone Number: | 5075377070 |
| Fax Number: | 5075377074 |
| NPI Enumeration Date: | 08/03/2006 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 8491260 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |