Healthcare Provider Details

I. General information

NPI: 1093533697
Provider Name (Legal Business Name): S&M HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 UNIVERSITY AVE W STE 221
SAINT PAUL MN
55104-3592
US

IV. Provider business mailing address

1955 UNIVERSITY AVE W STE 221
SAINT PAUL MN
55104-3592
US

V. Phone/Fax

Practice location:
  • Phone: 612-913-6862
  • Fax:
Mailing address:
  • Phone: 612-913-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHUKRI AHMED ALI
Title or Position: OWNER
Credential: RN
Phone: 612-913-6862