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General NPI Number Information
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NPI Number | 1154870459
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Entity Type | Organization
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Legal Business Name | HUMMING BIRD HOME CARE
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 901 COMO BLVD E #118
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City | SAINT PAUL
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State | MN
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Zip | 55103-1055
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Country | US
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Telephone | 651-846-9597
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Fax | 651-846-9597
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Provider Business Mailing Address
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Address Line | 901 COMO BLVD E #118
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City | SAINT PAUL
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State | MN
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Zip | 55103-1055
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Country | US
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Telephone | 651-846-9597
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Fax | 651-846-9597
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DIRK J BEUKES
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Credential | M.D
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Telephone | 651-846-9597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MN
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