| Avera Mckennan | |
|
421 Main St Fairfax SD 57335-0354 | |
| (605) 654-2366 | |
| Not Available |
| Full Name | Avera Mckennan |
|---|---|
| Speciality | Clinic/center |
| Location | 421 Main St, Fairfax, South Dakota |
| Authorized Official Name and Position | Julie N Norton (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 6053226375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Mckennan Po Box 354 421 Main Fairfax SD 57335-0354 Ph: (605) 654-2366 | Avera Mckennan 421 Main St Fairfax SD 57335-0354 Ph: (605) 654-2366 |
| NPI Number | 1215967203 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 03/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215967203 | NPI | - | NPPES |
| 0000028 | Other | SD | WELLMARK BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |