MEDICARE: NORLINE HEALTHCARE, INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52D2025813	OTHER		CLIA

General Provider Information

NPI Number	:	1912665779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORLINE HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	W227N16857 TILLIE LAKE CT
Second Line	:
City	:	JACKSON
State	:	WI
Zip	:	53037-9000
Country	:	US
Telephone Number	:	262-677-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	W227N16841 TILLIE LAKE CT
Second Line	:
City	:	JACKSON
State	:	WI
Zip	:	53037-9000
Country	:	US
Telephone Number	:	262-677-9200
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JEFFERY S JAWORSKI
Credential	:
Telephone Number	:	262-677-9200

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	04/17/2023

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Directions to “NORLINE HEALTHCARE, INC ” Practice Location

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