| Avera Medical Group Crofton | |
|
203 W Main St Crofton NE 68730-0425 | |
| (402) 388-2343 | |
| (402) 388-2554 |
| Full Name | Avera Medical Group Crofton |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 W Main St, Crofton, Nebraska |
| Authorized Official Name and Position | Douglas Ekeren (CEO/PRESIDENT) |
| Authorized Official Contact | 6056688321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Crofton Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-4933 | Avera Medical Group Crofton 203 W Main St Crofton NE 68730-0425 Ph: (402) 388-2343 |
| NPI Number | 1316206949 |
|---|---|
| Provider Enumeration Date | 05/16/2012 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 6103729066 |
|---|---|
| Medicare Enrollment ID | O20160819001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316206949 | NPI | - | NPPES |
| NA1399 | Other | NE | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Avera Medical Group Crofton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 W Main St, Crofton, NE 68730 Phone: 402-388-2343 Fax: 402-388-2554 |