Organization
COUNTY OF ISANTI
Active
Other names
Isanti County Public Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY GLENN BUTTACAVOLI (CHS ADMINISTRATOR/ DIRECTOR)
(763) 689-8284
Entity
Organization
Contact information
Practice address
555 18TH AVE SW, CAMBRIDGE, MN 55008
(763) 689-4071
(763) 689-8293
Mailing address
555 18TH AVE SW, CAMBRIDGE, MN 55008
(763) 689-4071
(763) 689-8293
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025957
PREFERRED ONE
MN
01
—
116467
UCARE
MN
05
—
399853300
—
MN
01
—
8220IS
BLUE CROSS BLUE SHIELD
MN
01
—
8300061
MEDICA
MN
01
—
8G633IF
BLUE CROSS BLUE SHIELD
MN
01
—
8G633IS
BLUE CROSS BLUE SHIELD
MN
Enumeration date
09/15/2006
Last updated
04/13/2020
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