| Avera Mckennan | |
|
916 Holder St Larchwood IA 51241-0008 | |
| (712) 477-2185 | |
| (712) 477-2186 |
| Full Name | Avera Mckennan |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 916 Holder St, Larchwood, Iowa |
| Authorized Official Name and Position | Julie N Norton (SR 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 86430 Sioux Falls SD 57118-6430 Ph: (605) 322-4900 | Avera Mckennan 916 Holder St Larchwood IA 51241-0008 Ph: (712) 477-2185 |
| NPI Number | 1871527507 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871527507 | NPI | - | NPPES |
| 0425074 | Medicaid | IA | |
| 2900993 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |