=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407048457
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONSUMER CHOICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2007
-----------------------------------------------------
Last Update Date | 08/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1011 1ST ST S SUITE 315
-----------------------------------------------------
City | HOPKINS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55343-9413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-935-3515
-----------------------------------------------------
Fax | 952-935-7112
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1011 1ST ST S SUITE 315
-----------------------------------------------------
City | HOPKINS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55343-9413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-935-3515
-----------------------------------------------------
Fax | 952-935-7112
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | KATHY HENDRICKSON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 952-935-3515
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------