MEDICARE: PLOENA HOANG

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	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376993816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PLOENA HOANG

Provider Business Mailing Address
First Line	:	5923 SHETLAND DR NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-3739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5923 SHETLAND DR NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-3739
Country	:	US
Telephone Number	:	612-321-8731
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2016
Last Update Date	:	07/07/2016

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Directions to “ PLOENA HOANG ” Practice Location

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