| Organization Name: | COUNTY OF PINE |
| NPI Number: | 1073635249 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSS BARON (FISCAL SUPERVISER) |
| Mailing Address: | 1610 Highway 23 N Sandstone |
| State: | MN US |
| Postal Code: | 550725009 |
| Phone Number: | 3202164140 |
| Fax Number: | 3202164101 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 03/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |