Provider Demographics
NPI:1164102661
Name:AITKIN COMMUNITY HOSPITAL INC.
Entity Type:Organization
Organization Name:AITKIN COMMUNITY HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNKO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:218-768-4165
Mailing Address - Street 1:241 W HIGHWAY 210
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:MN
Mailing Address - Zip Code:55760-5009
Mailing Address - Country:US
Mailing Address - Phone:218-768-4165
Mailing Address - Fax:218-768-3404
Practice Address - Street 1:241 W HIGHWAY 210
Practice Address - Street 2:
Practice Address - City:MCGREGOR
Practice Address - State:MN
Practice Address - Zip Code:55760-5009
Practice Address - Country:US
Practice Address - Phone:218-768-4165
Practice Address - Fax:218-768-3404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AITKIN COMMUNITY HOSPITAL INC.,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-19
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy