Avera Mckennan
Long Term Care Pharmacy
4101 W Memory Circle, Ste 120, Sioux Falls
South Dakota, 57107-6504
855-322-6922 855-971-3544
Avera Mckennan is a Long Term Care Pharmacy in Sioux Falls, South Dakota. It is located at 4101 W Memory Circle, Ste 120, Sioux Falls and it's customer support contact number is 855-322-6922. The authorized person of Avera Mckennan is Ronald Joseph Place, MD who is President/ceo of the pharmacy and his contact number is 605-322-7903. Active license number of Avera Mckennan is 100-1994 for Long Term Care Pharmacy in South Dakota. Avera Mckennan accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Avera Mckennan is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Pharmacy Details:
Avera Mckennan type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Avera Mckennan |
| Type: | Long Term Care Pharmacy |
| Location: | 4101 W Memory Circle, Ste 120, Sioux Falls,
South Dakota, 57107-6504 |
| Phone: | 855-322-6922 |
| Fax: | 855-971-3544 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Ronald Joseph Place |
| Credentials: | MD |
| Position: | President/ceo |
| Contact Number: | 605-322-7903 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1669871000 |
| NPI Enumeration Date: | 21 Aug, 2014 |
| NPI Last Update On: | 29 Apr, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Avera Mckennan are as mentioned below.
| Specialization | License Number | State | Status | |
| Long Term Care Pharmacy | 100-1994 | South Dakota | Primary | |
| Pharmacy | | | Secondary | |
| Community/Retail Pharmacy | | | Secondary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Compounding Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2147429 | Other | | Pk |
Medicare Enrollment:
Avera Mckennan is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 0345157103 | O20081124000161 | Avera Mckennan | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 0345157103 | O20150310002111 | Avera Mckennan | DME SUPPLIER - PHARMACY |
Products Available:
Avera Mckennan has following products available for sale under medicare.
| Products: |
|---|
| • Infusion Pumps & Supplies: External Infusion | • Parenteral Equipment And/or Supplies |
| • Parenteral Nutrients | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 3820 N Potsdam Ave Ste 2,
Sioux Falls, South Dakota |
| Zip: | 57104-7057 |
| Phone Number: | 605-322-1450 |
| Fax Number: | 605-322-1451 |
Patients can reach Avera Mckennan at
4101 W Memory Circle, Ste 120, Sioux Falls, South Dakota or can
call on customer care at 855-322-6922.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.