Avera McKennan
NPI 1962787440ActiveOrganization· Pharmacy· Sioux Falls, SD
Pharmacy in Sioux Falls, South Dakota, registered in NPPES in October 2011. The authorized official on file is Darrel Mutchler, PHARMD, Retail Pharmacy Manager. Enrolled in Medicare as dme supplier - pharmacy.
Overview
| NPI | 1962787440 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 17, 2011 |
| Last updated in NPPES | Jul 19, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 4574 | IA |
| Pharmacy | 333600000X | 100-1967 | SD |
| Pharmacy | 333600000X | 1020 | NE |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 054.019698 | IL |
| Pharmacy, Specialty Pharmacy | 3336S0011X | 264333 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (SD) |
|---|
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