AVERA QUEEN OF PEACE NPI 1710155460

NPI Information

NPI: 1710155460
Provider Name: AVERA QUEEN OF PEACE

Doing Business As: AVERA DE SMET MEMORIAL HOSPITAL

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
306 PRAIRIE AVE SW
DE SMET, SD
ZIP 57231
Phone: (605) 854-3329
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AVERA QUEEN OF PEACE is a critical access general acute care hospital in De Smet, SD. AVERA QUEEN OF PEACE NPI is 1710155460. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera De Smet Memorial Hospital.

The provider's business location address is:

306 PRAIRIE AVE SW
DE SMET, SD
ZIP 57231-285
Phone: (605) 854-3329
Fax: (605) 854-3161

The provider's authorized official is Douglas Ekeren .
The authorized official title is President And Cfo and has the following contact phone number (605) 668-8321.

The CLIA number assigned to this NPI record is 43D0407358 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/15/2008 and was last updated on 8/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access		SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0100860	MEDICAID	SOUTH DAKOTA
2	5500860	MEDICAID	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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