| Avera Mckennan | |
|
301 Flynn Dr Milbank SD 57252-1508 | |
| (605) 432-4587 | |
| Not Available |
| Full Name | Avera Mckennan |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Flynn Dr, Milbank, South Dakota |
| Authorized Official Name and Position | Ronald Joseph Place (PRESIDENT/CEO) |
| Authorized Official Contact | 6053227903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Mckennan Po Box 5045 Cbo Prov Enrlmt Sioux Falls SD 57117-5045 Ph: (605) 322-6428 | Avera Mckennan 301 Flynn Dr Milbank SD 57252-1508 Ph: (605) 432-4587 |
| NPI Number | 1750488730 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 03/12/2024 |
| Medicare PECOS PAC ID | 0345157103 |
|---|---|
| Medicare Enrollment ID | O20091214000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750488730 | NPI | - | NPPES |
| 10148 | Other | SD | MEDICAID SD |
| 43D0407375 | Other | CLIA | |
| 148019700 | Other | MN MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Wapiti Medical Group Limited Company Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Flynn Dr Ste 600, Milbank, SD 57252 Phone: 605-554-0858 |