Healthcare Provider Details

I. General information

NPI: 1578735833
Provider Name (Legal Business Name): COUNTY OF MURRAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N ST PAUL AVE
FULDA MN
56131-1156
US

IV. Provider business mailing address

2042 JUNIPER AVE
SLAYTON MN
56172-1017
US

V. Phone/Fax

Practice location:
  • Phone: 507-836-1274
  • Fax: 507-836-1275
Mailing address:
  • Phone: 507-836-1274
  • Fax: 507-836-1275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMN

VIII. Authorized Official

Name: MS. RENEE M. LOGAN
Title or Position: CFO
Credential:
Phone: 507-836-1274