Healthcare Provider Details

I. General information

NPI: 1629066576
Provider Name (Legal Business Name): CW HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 LITTLE CANADA RD E STE 4
SAINT PAUL MN
55117-1343
US

IV. Provider business mailing address

80 LITTLE CANADA RD E STE 4
SAINT PAUL MN
55117-1343
US

V. Phone/Fax

Practice location:
  • Phone: 952-426-4812
  • Fax: 952-658-6853
Mailing address:
  • Phone: 952-426-4812
  • Fax: 952-658-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2823896
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number2823896
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number2823896
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number2823896
License Number StateMN

VIII. Authorized Official

Name: ANDREW REINHARDT
Title or Position: PRESIDENT
Credential:
Phone: 612-300-7747