Organization · Type 2 NPI

Avera St. Mary's

Medical Specialty Clinic/Center · Pierre, SD

NPI number 1124464128 Active

Practice location

801 E Sioux Ave
Pierre, SD 57501-3323

Call (605) 224-3100 Map

Fax (605) 224-8339

Mailing address

PO Box 5045, Cbo Palm Place Prv Enrlmt
Sioux Falls, SD 57117-5045

Specialties and licenses

Taxonomy	Code	License
Medical Specialty Clinic/Center Primary	261QM2500X	None listed

Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

49 other providers at this address

NPI record

NPI: 1124464128
Entity type: Organization (Type 2)
Issued: May 16, 2013
Last updated: Jul 15, 2022
Status: Active
Subpart: Yes of Avera St. Mary's Hospital Child Assessment Center

Other names

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Avera St. Mary's Hospital · doing business as
Avera St. Mary's Hospital · doing business as

Authorized official

Mikel Holland
CEO/president
(605) 224-3144

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124464128

Avera St. Mary's's National Provider Identifier is 1124464128, issued on May 16, 2013. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Pierre, SD. The record was last updated on Jul 15, 2022.