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County Of Itasca
Public Health or Welfare Agency in Grand Rapids, Minnesota
NPI 1619003076

County Of Itasca is a Public Health or Welfare Agency based in Grand Rapids, MN. County Of Itasca practices in Grand Rapids, MN. The NPI Number for County Of Itasca is 1619003076 and holds a License No. 241569 (Minnesota).

The current practice location address for County Of Itasca is 1209 Se 2Nd Ave, Grand Rapids, MN and can be reached out via phone at 218-327-2941 and via fax at 218-327-5547.

Location: 1209 Se 2Nd Ave, Grand Rapids, MN, 55744-3982
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1619003076
Provider Name
County Of Itasca
Credential
Provider Entity Type
Organization
Address
1209 Se 2Nd Ave, Grand Rapids, MN, 55744-3982
Phone Number
218-327-2941
Fax Number
218-327-5547
Provider Enumeration Date
02/27/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
730000011 01 MN MEDICARE PTAN
54029IT 01 MN MNCARE BLUE PLUS
768553000 05 MN
institution
Provider Business Practice Location Address Details
Address
1209 Se 2Nd Ave
City
Grand Rapids
State
Minnesota
Zip
55744-3982
Phone Number
218-327-2941
Fax Number
218-327-5547
person
Provider Business Mailing Address Details
Address
1209 Se 2Nd Ave
City
Grand Rapids
State
Minnesota
Zip
55744-3982
Phone Number
218-327-2941
Fax Number
218-327-5547
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Public Health or Welfare
Speciality
-
Taxonomy
251K00000X
License No.
241569 (Minnesota)
Definition
Definition to come...
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