| NPI | 1033114731 |
|---|---|
| Doing Business As | AVERA BRADY DME SUPPLIER |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS EKEREN President/CEO 605-668-8322 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: SD n/a) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SD 10652) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-08-20 |