| NPI | 1346266202 |
|---|---|
| Doing Business As | AVERA SPECIALTY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RONALD JOSPEH PLACE President/CEO 605-322-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: SD 100-1867) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy (Licence: MN 261725) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 3254) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TX 30747) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: AZ Y006781) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NE 637) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: ND Phar396) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-09-07 |