Healthcare Provider Details
I. General information
NPI: 1861639197
Provider Name (Legal Business Name): AVERA QUEEN OF PEACE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2009
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 GRASSLAND DR
MITCHELL SD
57301-6205
US
IV. Provider business mailing address
PO BOX 86370
SIOUX FALLS SD
57118-6370
US
V. Phone/Fax
- Phone: 605-995-7000
- Fax: 605-995-4911
- Phone: 605-322-4933
- Fax: 605-504-9489
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HILARY
R.
ROCKWELL
Title or Position: REGIONAL PRESIDENT / CEO
Credential:
Phone: 605-995-2200