Healthcare Provider Details

I. General information

NPI: 1780844928
Provider Name (Legal Business Name): BARWAAQO HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4106 SCOTT AVE N
ROBBINSDALE MN
55422-1754
US

IV. Provider business mailing address

4106 SCOTT AVE N
ROBBINSDALE MN
55422-1754
US

V. Phone/Fax

Practice location:
  • Phone: 612-388-0331
  • Fax: 763-535-0202
Mailing address:
  • Phone: 612-388-0331
  • Fax: 763-535-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateMN

VIII. Authorized Official

Name: FOWZIA A HARUM
Title or Position: OWENER
Credential:
Phone: 612-388-0331