MEDICARE: UNITED HOME CARE 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	302F00000X	Exclusive Provider Organization	383938451	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942602081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED HOME CARE INC

Provider Business Mailing Address
First Line	:	7748 FLORIDA CIR N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-2724
Country	:	US
Telephone Number	:	763-587-8920
Fax Number	:	612-521-9917

Provider Business Practice Location Address
First Line	:	7748 FLORIDA CIR N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-2724
Country	:	US
Telephone Number	:	763-587-8920
Fax Number	:	612-521-9917

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHNNY THAO
Credential	:
Telephone Number	:	763-587-8920

Provider Enumeration Date	:	09/19/2014
Last Update Date	:	09/20/2014

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Directions to “UNITED HOME CARE INC ” Practice Location

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