| Avera Medical Group Corsica | |
|
265 Main Street Corsica SD 57328 | |
| (605) 946-5411 | |
| (605) 946-5206 |
| Full Name | Avera Medical Group Corsica |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 265 Main Street, Corsica, South Dakota |
| Authorized Official Name and Position | Douglas Ekeren (PRESIDENT/CEO) |
| Authorized Official Contact | 6056688322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Corsica 525 N Foster St Mitchell SD 57301-2966 Ph: (605) 995-2000 | Avera Medical Group Corsica 265 Main Street Corsica SD 57328 Ph: (605) 946-5411 |
| NPI Number | 1932105046 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 08/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932105046 | NPI | - | NPPES |
| CR0890 | Other | SD | MEDICARE RR |
| 5306742 | Medicaid | SD | |
| 5306743 | Medicaid | SD | |
| 0000018 | Other | SD | WELLMARK |
| A-87545 | Other | SD | MULTIPLAN |
| 00-00435 | Other | SD | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | N/A (South Dakota) | Primary |
Prairie Health Clinic - Corsica Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 Main St, Corsica, SD 57328 Phone: 605-946-5959 Fax: 605-946-5616 | |
Avera Medical Group Corsica Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 265 Main Street, Corsica, SD 57328 Phone: 605-946-5411 Fax: 605-946-5206 |