1821156183 NPI number — COUNTY OF SCOTT

Table of content: (NPI 1821156183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821156183 NPI number — COUNTY OF SCOTT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF SCOTT
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:
SCOTT COUNTY HUMAN SERVICES - PUBLIC HEALTH
Provider Other Organization Name Type Code:
5
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:
1821156183
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 4TH AVE W
Provider Second Line Business Mailing Address:
GOVERNMENT CENTER ROOM 300
Provider Business Mailing Address City Name:
SHAKOPEE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55379-1220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-445-7751
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1615 WESTON CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAKOPEE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55379-4426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-496-8584
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SELVIG
Authorized Official First Name:
PAM
Authorized Official Middle Name:
Authorized Official Title or Position:
HEALTH AND HUMAN SERVICES DIRECTOR
Authorized Official Telephone Number:
952-496-8398

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 939053700 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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