AVERA QUEEN OF PEACE (NPI# 1710359252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710359252 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA GRASSLAND PHARMACY |
| Practice Address |
1900 Grassland Dr Ste 101 Mitchell SD 57301 |
| Practice Telephone | 6059955670 |
| Practice Fax Number | 6059966805 |
| Mailing Telephone | 6059955670 |
| Mailing Fax Number | 6059966805 |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | DOUGLAS EKEREN (PRESIDENT/CEO) |
| Authorized Official Telephone | 6056688321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
100-2030 | SD | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2154706 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Grassland Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568986040 | Avera Queen of Peace | Internal Medicine | 605 N Foster St Ste 100, Mitchell, SD 57301-2902 | 2017-07-27 |
| 1689051682 | Avera Queen of Peace | Clinic/Center | 409 S Ohlman St, Mitchell, SD 57301-3106 | 2015-04-29 |
| 1649577297 | Avera Queen of Peace | Clinic/Center | 1900 Grassland Dr., Mitchell, SD 57301-6205 | 2011-02-17 |
| 1053557967 | Avera Queen of Peace | Physician Assistant | 115 Second St Se, De Smet, SD 57231-0463 | 2008-12-23 |
| 1699972422 | Avera Queen of Peace | Specialist | 625 N Foster St Ste 200, Mitchell, SD 57301-2968 | 2007-06-27 |
| 1992712921 | Avera Queen of Peace | Pharmacy | 609 1st St Ne, Wessington Springs, SD 57382-2136 | 2006-08-02 |
| 1932105046 | Avera Queen of Peace | Clinic/Center | 265 Main Street, Corsica, SD 57328 | 2005-06-23 |
| 1326043092 | Avera Queen of Peace | Clinic/Center | 213 South Main, Howard, SD 57349 | 2005-06-17 |
| 1316942204 | Avera Queen of Peace | Clinic/Center | 604 1st St Ne, Wessington Springs, SD 57382-2134 | 2005-06-16 |
| 1639174568 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2005-06-16 |
| Street Address |
1900 GRASSLAND DR STE 101 |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306943576 | Xenofon Papadopoulos | Urology | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2006-09-20 |
| 1952911877 | Nancy Jo Miller | Dietitian, Registered | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2020-08-05 |
| 1669027678 | Rural Health Care, Inc | Family Medicine | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-08-06 |
| 1033762984 | Theresa Miiller | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-07-19 |
| 1649831637 | Maggie Riggs | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-06-21 |
| 1154896801 | Angela Mae Broughton | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2018-10-09 |
| 1417495649 | Laura Axsom | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2017-02-08 |
| 1881049484 | Avera Queen of Peace | Dermatology | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2016-05-02 |
| 1780055780 | Lacey Bonte | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2015-10-15 |
| 1972981330 | Thad Kandel | Surgery | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2015-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1538262233 | Hook Superx LLC | Pharmacy | 8830 State Road 60 W, Mitchell, IN 47446-7547 | 2006-09-07 |
| 1841732757 | Engleking Rx, LLC | Pharmacy | 1494 W Main St, Mitchell, IN 47446-9493 | 2016-11-08 |
| 1851713218 | Sears Holding Co | Pharmacy | 1313 S Burr St, Mitchell, SD 57301-4758 | 2014-01-19 |
| 1235570714 | Mitchell Drug | Pharmacy | 1456 Center Ave, Mitchell, NE 69357-1448 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144868514 | Dakota Pharms, LLC | Pharmacy | 120 Commercial Ave Se, Highmore, SD 57345-2145 | 2019-12-17 |
| 1831675438 | Lewis Drugs, Inc. | Pharmacy | 2525 S Ellis Rd, Sioux Falls, SD 57106-7066 | 2018-07-17 |
| 1104302702 | Lewis Drugs, Inc. | Pharmacy | 136 S Phillips Ave, Sioux Falls, SD 57104-6706 | 2018-07-17 |
| 1316463219 | Avera Mckennan | Pharmacy | 1200 S. 7th Avenue, Suite 101, Sioux Falls, SD 57105 | 2017-08-22 |
| 1487109690 | Monument Health Home Plus, LLC | Pharmacy | 2006 Mount Rushmore Rd Ste 2, Rapid City, SD 57701-4622 | 2016-08-17 |
| 1316342306 | Dpx Enterprises, Inc. | Pharmacy | 5028 S Cliff Ave, Sioux Falls, SD 57108-5432 | 2014-11-03 |
| 1700125259 | Rapid City Regional Hospital, Inc. | Pharmacy | 1906 Lombardy Drive, Suite 102, Rapid City, SD 57703 | 2013-02-04 |
| 1609178565 | Hy Vee Inc | Pharmacy | 2700 W 10th St, Sioux Falls, SD 57104-2547 | 2010-11-29 |
| 1447450994 | Your Daily Dose, Inc. | Pharmacy | 220 South Cliff Ave., Harrisburg, SD 57032 | 2007-07-23 |
| 1023173168 | Wall Drug Store, Inc. | Pharmacy | 510 Main Street, Wall, SD 57790-0401 | 2006-12-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.