1851396402 NPI number — COUNTY OF TODD

Table of content: (NPI 1851396402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851396402 NPI number — COUNTY OF TODD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF TODD
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:
1851396402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
212 2ND AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56347-1608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-732-4500
Provider Business Mailing Address Fax Number:
320-732-4445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
212 2ND AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-4500
Provider Business Practice Location Address Fax Number:
320-732-4445
Provider Enumeration Date:
06/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
OCH
Authorized Official First Name:
JACQUELYN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
320-732-4500

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 326500 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 187669 . This is a "MAYOMANAGEMENT SERVICES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 231861034754 . This is a "PREFERREDONE 837P" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5900161 . This is a "MEDICA 837P PROVIDER NUMB" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1021805 . This is a "PREFERREDONE 837I PROVIDE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 116159 . This is a "UCARE PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8294TO . This is a "BLUE CROSS PROVIDER NUMBE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8302311 . This is a "MEDICA 837I PROVIDER NUMB" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 23G18TO . This is a "BLUE SHIELD PROVIDER NUM" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 690255300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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