Healthcare Provider Details

I. General information

NPI: 1699612416
Provider Name (Legal Business Name): CITY OF AVON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MAIN ST N
AVON SD
57315-2058
US

IV. Provider business mailing address

PO BOX 207
AVON SD
57315-0207
US

V. Phone/Fax

Practice location:
  • Phone: 605-286-3694
  • Fax: 605-286-3122
Mailing address:
  • Phone: 605-286-3694
  • Fax: 605-286-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA ROSE RADACK
Title or Position: FINANCE OFFICER
Credential:
Phone: 605-286-3694