Healthcare Provider Details
I. General information
NPI: 1699972422
Provider Name (Legal Business Name): AVERA QUEEN OF PEACE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2007
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 N FOSTER ST STE 200
MITCHELL SD
57301-2968
US
IV. Provider business mailing address
PO BOX 86370
SIOUX FALLS SD
57118-6370
US
V. Phone/Fax
- Phone: 605-995-3463
- Fax: 605-996-0718
- Phone: 605-322-4933
- Fax: 605-504-9489
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HILARY
R.
ROCKWELL
Title or Position: REGIONAL PRESIDENT / CEO
Credential:
Phone: 605-995-2200