1477795995 NPI number — N&V HELPFUL HEART CARE INC,

Table of content: (NPI 1477795995)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477795995 NPI number — N&V HELPFUL HEART CARE INC,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
N&V HELPFUL HEART CARE INC,
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
N&V HELPFUL HEART CARE INC,
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477795995
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VERA DIXON
Provider Second Line Business Mailing Address:
6000 BASS LAKE RD SUITE 106
Provider Business Mailing Address City Name:
CRYSTAL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55429-2453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-442-0460
Provider Business Mailing Address Fax Number:
763-226-2397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6000 BASS LAKE RD
Provider Second Line Business Practice Location Address:
# 210
Provider Business Practice Location Address City Name:
CRYSTAL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-218-8685
Provider Business Practice Location Address Fax Number:
763-537-0040
Provider Enumeration Date:
03/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DIXON
Authorized Official First Name:
VERA
Authorized Official Middle Name:
GARLEY
Authorized Official Title or Position:
OWNER/ CEO
Authorized Official Telephone Number:
763-442-0460

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  339941 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ========= . This is a "HOME CARE CLASS A AGACY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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