1356447544 NPI number — COUNTY OF REDWOOD

Table of content: (NPI 1356447544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356447544 NPI number — COUNTY OF REDWOOD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF REDWOOD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REDWOOD COUNTY PUBLIC HEALTH SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356447544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
266 E BRIDGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDWOOD FALLS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56283-1664
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-637-4041
Provider Business Mailing Address Fax Number:
507-637-4046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
266 E BRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDWOOD FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56283-1664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-637-4041
Provider Business Practice Location Address Fax Number:
507-637-4046
Provider Enumeration Date:
09/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIMON
Authorized Official First Name:
EUGENIE
Authorized Official Middle Name:
RAE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
507-637-4041

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  02096 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5900224 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8300109 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8G537RE . This is a "BCBS PUBLIC HEALTH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 114584 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8252RE . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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