Provider Demographics
NPI:1629319561
Name:COOK AREA HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:COOK AREA HEALTH SERVICES, INC
Other - Org Name:SCENIC RIVER HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-666-5102
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:952-653-2525
Mailing Address - Fax:
Practice Address - Street 1:415 N 2ND ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TOWER
Practice Address - State:MN
Practice Address - Zip Code:55790
Practice Address - Country:US
Practice Address - Phone:218-666-5941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOK AREA HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-01
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site