| Avera St Lukes | |
|
305 S State St Aberdeen SD 57401-4527 | |
| (605) 622-5000 | |
| (605) 622-5255 |
| Full Name | Avera St Lukes |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 305 S State St, Aberdeen, South Dakota |
| Authorized Official Name and Position | Tess Moeller (EXEC VP) |
| Authorized Official Contact | 6056222807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera St Lukes 305 S State St Aberdeen SD 57401-4527 Ph: (605) 622-5000 | Avera St Lukes 305 S State St Aberdeen SD 57401-4527 Ph: (605) 622-5000 |
| NPI Number | 1003867029 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Medicare PECOS PAC ID | 6406764927 |
|---|---|
| Medicare Enrollment ID | O20070612000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003867029 | NPI | - | NPPES |
| 2381 | Medicaid | ND | |
| 0230330 | Medicaid | SD | |
| 0230332 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 10525 (South Dakota) | Primary |
| 283Q00000X | Psychiatric Hospital | 10525 (South Dakota) | Secondary |
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