Healthcare Provider Details

I. General information

NPI: 1780659540
Provider Name (Legal Business Name): SAEED HUSSEIN FARAH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 PILLSBURY AVE
MINNEAPOLIS MN
55408-2255
US

IV. Provider business mailing address

2940 PILLSBURY AVE
MINNEAPOLIS MN
55408-2275
US

V. Phone/Fax

Practice location:
  • Phone: 612-823-4305
  • Fax: 612-823-4263
Mailing address:
  • Phone: 612-823-4305
  • Fax: 612-823-4263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number328162
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: