Provider Demographics
NPI:1356447544
Name:COUNTY OF REDWOOD
Entity type:Organization
Organization Name:COUNTY OF REDWOOD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EUGENIE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:RN/PHS
Authorized Official - Phone:507-637-4041
Mailing Address - Street 1:266 E BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-1664
Mailing Address - Country:US
Mailing Address - Phone:507-637-4041
Mailing Address - Fax:507-637-4046
Practice Address - Street 1:266 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1664
Practice Address - Country:US
Practice Address - Phone:507-637-4041
Practice Address - Fax:507-637-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02096251E00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5900224OtherMEDICA
MN8300109OtherMEDICA
MN8G537REOtherBCBS PUBLIC HEALTH
MN114584OtherUCARE
MN8252REOtherBCBS
MN247077Medicare ID - Type Unspecified