1952555146 NPI number — COUNTY OF MEEKER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952555146 NPI number — COUNTY OF MEEKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF MEEKER
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:
Provider Other Organization Name Type Code:
6
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:
1952555146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
612 S SIBLEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITCHFIELD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55355-3340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-693-4500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
740 PARKER AVE W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DASSEL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55325-1024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-275-4330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SIEGNER
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
320-693-4512

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 030047100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 122N4ME . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 300200 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5003920 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1006108 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1387 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 3947030 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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