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Nursing Facility Supplies, Customized Equipment

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AVERA MCKENNAN

Parenteral and Enteral Nutrition

Sioux Falls, South Dakota

Provider NPI: 1164492906

Organization Information:
Organization Name:  AVERA MCKENNAN


Practice Location:
1020 S CLIFF AVE  SIOUX FALLS, SD 57104 US
Tel: 605-322-8322  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
SD100-1663
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
SD100-1663
N333600000XSuppliers
Pharmacy
SD1001663
N3336H0001XSuppliers
Pharmacy
SD100-1663
N3336S0011XSuppliers
Pharmacy
SD100-1663
Y251F00000XAgencies
Home Infusion
SD1001663

Other Provider Identifiers:

IssuerNumberStateType
4304971IA05
350516200MN05
8504010SD05
9166500SD05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




NUTRITION JOBS SD - Page 1



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