Provider Demographics
NPI:1255436721
Name:COUNTY OF AITKIN
Entity type:Organization
Organization Name:COUNTY OF AITKIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-927-7200
Mailing Address - Street 1:204 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-1260
Mailing Address - Country:US
Mailing Address - Phone:218-927-7200
Mailing Address - Fax:218-927-7461
Practice Address - Street 1:204 1ST ST NW
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-1260
Practice Address - Country:US
Practice Address - Phone:218-927-7200
Practice Address - Fax:218-927-7461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7C16CAIOtherBC/BS MULTI SPECIALITY
MN8460714OtherMEDICA RULE 25
MN52F92AIOtherBC/BS RULE 25
MN07Z44AIOtherBC/BS PMAP MILEAGE
MN0Z00AIOtherBC/BS DETOX
MN277553100Medicaid
MN035H7AIOtherBC/BS MASS IMMUNIZATION
MN5900201OtherMEDICA HOME VISIT
MN683P3AIOtherBC/BS MH-TCM
MN125245OtherUCARE
MN38P89AIOtherBC/BS
MN130955OtherUCARE OTHER
MN8300100OtherMEDICA IMMUNIZATIONS
MN870000817Medicare PIN