Organization
COUNTY OF ISANTI
Active
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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