MEDICARE: INTERNATIONAL QUALITY HOMECARE CORP

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

General Provider Information

NPI Number	:	1861888422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL QUALITY HOMECARE CORP

Provider Business Mailing Address
First Line	:	3261 19TH ST NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-6786
Country	:	US
Telephone Number	:	507-252-8117
Fax Number	:	507-252-1985

Provider Business Practice Location Address
First Line	:	2395 W WASHINGTON ST
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53095-2147
Country	:	US
Telephone Number	:	262-623-6301
Fax Number	:	262-429-1400

Authorized Official
Title or Position	:	PRESIDENT &CHIEF EXECUTIVE OFFICER
Name	:	DR. ADERONKE OLANREWAJU MORDI
Credential	:
Telephone Number	:	507-252-8117

Provider Enumeration Date	:	04/10/2015
Last Update Date	:	04/10/2015

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