Provider Demographics
NPI:1578004883
Name:SACRED HEART HEALTH SERVICES
Entity Type:Organization
Organization Name:SACRED HEART HEALTH SERVICES
Other - Org Name:AVERA MEDICAL GROUP FAMILY MEDICINE YANKTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EKEREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-668-8321
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-4933
Mailing Address - Fax:605-504-9489
Practice Address - Street 1:2525 FOX RUN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-5371
Practice Address - Country:US
Practice Address - Phone:605-260-2100
Practice Address - Fax:605-260-2104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACRED HEART HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-20
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty