1205270899 NPI number — MIDWEST QUALITY HOME CARE INC

Table of content: (NPI 1205270899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205270899 NPI number — MIDWEST QUALITY HOME CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST QUALITY HOME 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:
Provider Other Organization Name Type Code:
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:
1205270899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1433 E FRANKLIN AVE
Provider Second Line Business Mailing Address:
SUITE # 1
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55404-2101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-343-4004
Provider Business Mailing Address Fax Number:
612-343-4007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1433 E FRANKLIN AVE
Provider Second Line Business Practice Location Address:
SUITE # 1
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55404-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-343-4004
Provider Business Practice Location Address Fax Number:
612-343-4007
Provider Enumeration Date:
04/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FARAH
Authorized Official First Name:
SAID
Authorized Official Middle Name:
Authorized Official Title or Position:
HUMAN RESOURCE MANAGER
Authorized Official Telephone Number:
612-343-4004

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  R165007 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: R205663 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: R1764992 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: R1752027 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: R212457-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: R 214603-0 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 215981-0 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: R199730-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 219215-2 , 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)

  • Identifier: 215981-0 . This is a "1114358009" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R 214603-0 . This is a "M477417200" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R205663 . This is a "A228117200" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R165007 . This is a "A188427300" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1752027 . This is a "M096428000" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 219215-2 . This is a "1265845275" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R199730-3 . This is a "1578805479" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R212457-3 . This is a "A534643100" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1922401363 . This is a "RN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: R1764992 . This is a "A066612100" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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