Provider Demographics
NPI:1073676540
Name:COUNTY OF KANDIYOHI
Entity Type:Organization
Organization Name:COUNTY OF KANDIYOHI
Other - Org Name:KANDIYOHI COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-231-7800
Mailing Address - Street 1:2200 23RD ST NE
Mailing Address - Street 2:SUITE 1080
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-6600
Mailing Address - Country:US
Mailing Address - Phone:320-231-7860
Mailing Address - Fax:320-231-7888
Practice Address - Street 1:2200 23RD ST NE
Practice Address - Street 2:SUITE 1080
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-6600
Practice Address - Country:US
Practice Address - Phone:320-231-7860
Practice Address - Fax:320-231-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN114586OtherU-CARE
MN8G54OKAOtherBLUE PLUS
MN649853100Medicaid
MN2045AKAOtherBSBS OF MN