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General NPI Number Information
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NPI Number | 1831192764
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Entity Type | Organization
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Legal Business Name | COUNTY OF KOOCHICHING
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 1000 5TH ST
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City | INTERNATIONAL FALLS
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State | MN
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Zip | 56649-2243
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Country | US
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Telephone | 218-283-7070
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Fax | 218-283-7050
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Provider Business Mailing Address
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Address Line | 1000 5TH ST
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City | INTERNATIONAL FALLS
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State | MN
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Zip | 56649-2243
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Country | US
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Telephone | 218-283-7070
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Fax | 218-283-7050
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DEREK FOSS
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Credential |
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Telephone | 218-283-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 251E00000X
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License Number State | MN
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