| Eureka Medical Clinic Avera | |
|
200 J Ave Ste A Eureka SD 57437-2225 | |
| (605) 284-2661 | |
| (605) 284-2054 |
| Full Name | Eureka Medical Clinic Avera |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 J Ave Ste A, Eureka, South Dakota |
| Authorized Official Name and Position | Carmen Weber (ADMINISTRATOR) |
| Authorized Official Contact | 6052842661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eureka Medical Clinic Avera Po Box 517 Eureka SD 57437-0517 | Eureka Medical Clinic Avera 200 J Ave Ste A Eureka SD 57437-2225 Ph: (605) 284-2661 |
| NPI Number | 1881047371 |
|---|---|
| Provider Enumeration Date | 07/20/2016 |
| Last Update Date | 05/01/2020 |
| Certification Date | 05/01/2020 |
| Medicare PECOS PAC ID | 5698711653 |
|---|---|
| Medicare Enrollment ID | O20160825002692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881047371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Primary |
| Provider Name | Brian Ermer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417931908 PECOS PAC ID: 8729010830 Enrollment ID: I20050908001049 |
| Provider Name | Susan M Ostrowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851343933 PECOS PAC ID: 4082615059 Enrollment ID: I20070118000535 |
| Provider Name | Clint E Perman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386731719 PECOS PAC ID: 5496826455 Enrollment ID: I20080619000607 |
| Provider Name | Jeffrey S Bock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649274481 PECOS PAC ID: 5092802728 Enrollment ID: I20090804000050 |
| Provider Name | Cory Heiser |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326490129 PECOS PAC ID: 4385930304 Enrollment ID: I20160831000020 |
| Provider Name | Jamie Nicole Hartung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801521869 PECOS PAC ID: 1759764988 Enrollment ID: I20220819002080 |
| Provider Name | Jennifer L Frost |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750503611 PECOS PAC ID: 5395907372 Enrollment ID: I20230504002518 |
| Provider Name | Brianna L Dalchow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649055732 PECOS PAC ID: 1052767621 Enrollment ID: I20231212001965 |
| Provider Name | Susan a Berreth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730849001 PECOS PAC ID: 9739566704 Enrollment ID: I20241003000587 |
Eureka Medical Clinic Avera Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 J Ave Ste A, Eureka, SD 57437 Phone: 605-284-2621 Fax: 605-284-2623 |