1023071818 NPI number — CITY OF COKATO

Table of content: (NPI 1023071818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023071818 NPI number — CITY OF COKATO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF COKATO
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:
COKATO AMBULANCE 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:
1023071818
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1030
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55321-1030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-286-5505
Provider Business Mailing Address Fax Number:
320-286-5876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
255 BROADWAY AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COKATO
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-286-5505
Provider Business Practice Location Address Fax Number:
320-286-5876
Provider Enumeration Date:
04/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUSTAFSON
Authorized Official First Name:
MEGAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CLERK/TREASURER
Authorized Official Telephone Number:
320-286-5505

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 57050CO . This is a "BLUES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8182606 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 111058 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 174067900 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".