Provider Demographics
NPI:1770047334
Name:HENNEPIN COUNTY
Entity Type:Organization
Organization Name:HENNEPIN COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-348-2247
Mailing Address - Street 1:525 PORTLAND AVE. SO.
Mailing Address - Street 2:FL3 MC962
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415
Mailing Address - Country:US
Mailing Address - Phone:612-348-5553
Mailing Address - Fax:612-999-9999
Practice Address - Street 1:525 PORTLAND AVE. SO.
Practice Address - Street 2:FL3 MC962
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415
Practice Address - Country:US
Practice Address - Phone:612-348-5553
Practice Address - Fax:612-999-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare