Provider Demographics
NPI:1396818175
Name:COUNTY OF SIBLEY
Entity Type:Organization
Organization Name:COUNTY OF SIBLEY
Other - Org Name:SIBLEY COUNTY PUBLIC HEALTH AND HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KLEA
Authorized Official - Middle Name:MS
Authorized Official - Last Name:RETTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-237-4000
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MN
Mailing Address - Zip Code:55334-0237
Mailing Address - Country:US
Mailing Address - Phone:507-237-4035
Mailing Address - Fax:507-237-4031
Practice Address - Street 1:111 8TH STREET
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MN
Practice Address - Zip Code:55334
Practice Address - Country:US
Practice Address - Phone:507-237-4035
Practice Address - Fax:507-237-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
1022762OtherPREFERRED ONE
MN1396818175OtherBLUE CROSS AND BLUE SHIELD OF MN
MN110755100Medicaid
115485OtherSOUTH COUNTRY HEALTH ALLI
8300096OtherMEDICA