MEDICARE: MAYO HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1316172414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYO HOME CARE

Provider Business Mailing Address
First Line	:	310 E 38TH ST STE CR-I
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-821-2345
Fax Number	:	612-252-2417

Provider Business Practice Location Address
First Line	:	310 E 38TH ST STE CR-I
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-821-2345
Fax Number	:	612-252-2417

Authorized Official
Title or Position	:	PRESIDENT
Name	:	USAMA MUSA
Credential	:
Telephone Number	:	612-821-2345

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	05/19/2009

Similar Medicare Providers

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1639375421 — MS. JENNIFER LEIGH POHL L.P.
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1932450830 — BETH NELSON LMFT
Practice Location Address:

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Directions to “MAYO HOME CARE ” Practice Location

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