Provider Demographics
NPI:1760752414
Name:BROOKINGS HEALTH SYSTEM/AVERA HOME MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:BROOKINGS HEALTH SYSTEM/AVERA HOME MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-322-7818
Mailing Address - Street 1:100 22ND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2425
Mailing Address - Country:US
Mailing Address - Phone:605-692-6696
Mailing Address - Fax:605-692-6697
Practice Address - Street 1:100 22ND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2425
Practice Address - Country:US
Practice Address - Phone:605-692-6696
Practice Address - Fax:605-692-6697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10249799ST332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies