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General NPI Number Information
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NPI Number | 1275849044
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Entity Type | Organization
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Legal Business Name | HIDDO HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 1619 EASTWOOD RD SE
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City | ROCHESTER
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State | MN
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Zip | 55904-5168
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Country | US
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Telephone | 507-319-7168
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Fax | 507-206-6154
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Provider Business Mailing Address
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Address Line | 1619 EASTWOOD ROAD SE
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City | ROCHESTER
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State | MN
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Zip | 55904
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Country | US
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Telephone | 507-319-7168
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Fax | 507-206-6154
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMUD ALI NUR
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Credential |
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Telephone | 507-319-7168
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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 | M817281100
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License Number State | MN
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