Organization

Avera Mckennan

May also be knows as Avera Medical Group Fairfax

Clinic/Center in Fairfax, SD(View on Map)

Legal Business Name

Avera Mckennan

Also Known As

Avera Medical Group Fairfax

NPI Number

1215967203

NPI Type

Organization

Enumeration Date

07/04/2006

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 354
421 MAIN ST

City

Fairfax
Fairfax

State

SD
SD

Postal Code

57335-0354
57335-0354

Country

US
US

Telephone Number

(605) 654-2366
(605) 654-2366

Authorized Official

Name

Julie Norton

Title or Position

VICE PRESIDENT OF FINANCE

Telephone Number

(605) 322-6375

Identifiers

Identifier

0000028

Identifier State

SD

Identifier Issuer

WELLMARK BC/BS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/21/2011

Provider Address