1164548442 NPI number — COUNTY OF RICE

Table of content: (NPI 1164548442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164548442 NPI number — COUNTY OF RICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF RICE
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:
RICE COUNTY PUBLIC HEALTH NURSING 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:
1164548442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 3RD ST NW
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
FARIBAULT
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55021-5194
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-332-6111
Provider Business Mailing Address Fax Number:
507-332-5932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 3RD ST NW
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
FARIBAULT
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55021-5194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-332-6111
Provider Business Practice Location Address Fax Number:
507-332-5932
Provider Enumeration Date:
03/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PURFEERST
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
DIRECTOR OF PUBLIC HEALTH
Authorized Official Telephone Number:
507-332-5914

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  356216 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 34G83RI . This is a "BLUE CROSS CLINIC" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1026326 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 117192 . This is a "UCARE CLINICAL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5900195 . This is a "MEDICA HOME CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8256RI . This is a "BLUE CROSS HOME CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 400355100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300092 . This is a "MEDICA CLINICAL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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