Healthcare Provider Details

I. General information

NPI: 1821095563
Provider Name (Legal Business Name): COUNTY OF MOWER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 18TH AVE NW SUITE A
AUSTIN MN
55912-1888
US

IV. Provider business mailing address

1301 18TH AVE NW SUITE A
AUSTIN MN
55912-1888
US

V. Phone/Fax

Practice location:
  • Phone: 507-437-9770
  • Fax: 507-434-2695
Mailing address:
  • Phone: 507-437-9770
  • Fax: 507-434-2695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number328306
License Number StateMN

VIII. Authorized Official

Name: MS. MARGENE GUNDERSON
Title or Position: COMMUNITY HEALTH SERVICES DIRECTOR
Credential: PHN
Phone: 507-437-9770