Provider Demographics
NPI:1255333530
Name:COUNTY OF WABASHA
Entity Type:Organization
Organization Name:COUNTY OF WABASHA
Other - Org Name:WABASHA COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHN, DON
Authorized Official - Phone:651-565-5200
Mailing Address - Street 1:411 HIAWATHA DR E
Mailing Address - Street 2:
Mailing Address - City:WABASHA
Mailing Address - State:MN
Mailing Address - Zip Code:55981-1573
Mailing Address - Country:US
Mailing Address - Phone:651-565-5200
Mailing Address - Fax:651-565-2637
Practice Address - Street 1:411 HIAWATHA DR E
Practice Address - Street 2:
Practice Address - City:WABASHA
Practice Address - State:MN
Practice Address - Zip Code:55981-1573
Practice Address - Country:US
Practice Address - Phone:651-565-5200
Practice Address - Fax:651-565-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN325766251E00000X
MN251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN812814600Medicaid
MN124347OtherU-CARE INS PROVIDER #
MN2015AWAOtherBCBS OF MN PROVIDER #
MN2015UWAOtherBCBS OF MN PROVIDER #
MN2015AWAOtherBCBS OF MN PROVIDER #