| Avera Medical Group Hartington | |
|
405 W Darlene St Hartington NE 68739-4806 | |
| (402) 254-3935 | |
| (402) 254-2393 |
| Full Name | Avera Medical Group Hartington |
|---|---|
| Speciality | Clinic/Center |
| Location | 405 W Darlene St, Hartington, 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 Hartington Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-4933 | Avera Medical Group Hartington 405 W Darlene St Hartington NE 68739-4806 Ph: (402) 254-3935 |
| NPI Number | 1518226190 |
|---|---|
| Provider Enumeration Date | 05/16/2012 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 6103729066 |
|---|---|
| Medicare Enrollment ID | O20160819000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518226190 | NPI | - | NPPES |
| NA1399 | Other | NE | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Avera Medical Group Hartington Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 W Darlene St, Hartington, NE 68739 Phone: 402-254-3935 Fax: 402-254-2393 |