Provider Demographics
NPI:1174596027
Name:COOK AREA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:COOK AREA HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-361-3135
Mailing Address - Street 1:126 W 7TH AVE
Mailing Address - Street 2:BOX 426
Mailing Address - City:FLOODWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55736-0426
Mailing Address - Country:US
Mailing Address - Phone:218-476-2221
Mailing Address - Fax:218-476-2965
Practice Address - Street 1:810 POPLAR ST
Practice Address - Street 2:
Practice Address - City:FLOODWOOD
Practice Address - State:MN
Practice Address - Zip Code:55736-4002
Practice Address - Country:US
Practice Address - Phone:218-476-2221
Practice Address - Fax:218-476-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN288604900Medicaid
MNC03103Medicare PIN
MN24-1826Medicare PIN