Provider Demographics
NPI:1023071818
Name:CITY OF COKATO
Entity type:Organization
Organization Name:CITY OF COKATO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLERK/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSTAFSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-286-5505
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321-1030
Mailing Address - Country:US
Mailing Address - Phone:320-286-5505
Mailing Address - Fax:320-286-5876
Practice Address - Street 1:255 BROADWAY AVE S
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321
Practice Address - Country:US
Practice Address - Phone:320-286-5505
Practice Address - Fax:320-286-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN57050COOtherBLUES
MN8182606OtherMEDICA
MN111058OtherUCARE
MN174067900Medicaid
WI=========Medicaid
MN57050COOtherBLUES