NPI 1033114731

Avera Queen of Peace

Organisation Parenteral & Enteral Nutrition Supplies (DME) Mitchell, SD

Practice location

Address: 500 S Ohlman St, Mitchell, SD 57301-3109
Phone: (605) 996-7701
Mailing address: 525 N Foster St, Mitchell, SD 57301-2966

Authorised official

Name: Douglas Ekeren
Title: President/Ceo
Phone: (605) 668-8322

Registered specialties (2)

Parenteral & Enteral Nutrition Supplies (DME) Primary

Suppliers Taxonomy 332BP3500X Licence N/A (SD)

Other Durable Medical Equipment & Medical Supplies providers in South Dakota →

Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X Licence 10652 (SD)

Registry record

NPI: 1033114731
Entity type: Organization
NPI issued: 17 Jun 2005
Record last updated: 20 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.