| NPI | 1669871000 |
|---|---|
| Doing Business As | AVERA LONG TERM CARE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RONALD JOSEPH PLACE President/CEO 605-322-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: SD 100-1994) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2023-10-04 |