| Avera Queen Of Peace | |
|
741 S Hill St Salem SD 57058-8761 | |
| (605) 425-3038 | |
| (605) 425-3039 |
| Full Name | Avera Queen Of Peace |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 741 S Hill St, Salem, South Dakota |
| Authorized Official Name and Position | Douglas Ekeren (PRESIDENT/CEO) |
| Authorized Official Contact | 6056688322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Queen Of Peace 525 N Foster St Mitchell SD 57301-2966 Ph: (605) 995-2000 | Avera Queen Of Peace 741 S Hill St Salem SD 57058-8761 Ph: (605) 425-3038 |
| NPI Number | 1619201829 |
|---|---|
| Provider Enumeration Date | 09/22/2009 |
| Last Update Date | 08/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619201829 | NPI | - | NPPES |
| S1639 | Other | SD | MEDICARE PART B |
| 00-00592 | Other | SD | MEDICA |
| 4991003 | Other | SD | WELLMARK |
| 5307012 | Medicaid | SD | |
| CR0890 | Other | SD | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | NA (South Dakota) | Primary |
Avera Queen Of Peace Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 741 S Hill St, Salem, SD 57058 Phone: 605-425-3038 Fax: 605-425-3039 | |
Avera Mckennan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 740 S Hill St, Salem, SD 57058 Phone: 605-425-2855 Fax: 605-425-2149 |