1801059431 NPI number — IDIL SAID NUR

Table of content: (NPI 1801059431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801059431 NPI number — IDIL SAID NUR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IDIL SAID NUR
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:
FIRST CHOICE HOME HEALTH MINNESOTA
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:
1801059431
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1821 UNIVERSITY AVE W
Provider Second Line Business Mailing Address:
SUITE S-305
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55104-2801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-226-9485
Provider Business Mailing Address Fax Number:
651-222-3585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1821 UNIVERSITY AVE W
Provider Second Line Business Practice Location Address:
SUITE S-305
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55104-2801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-226-9485
Provider Business Practice Location Address Fax Number:
651-222-3585
Provider Enumeration Date:
07/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
NUR
Authorized Official First Name:
IDIL
Authorized Official Middle Name:
SAID
Authorized Official Title or Position:
PRESIDENT & OWNER
Authorized Official Telephone Number:
612-226-9485

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  25979 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X , with the licence number: R1757365 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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