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General NPI Number Information
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NPI Number | 1477552545
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Entity Type | Organization
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Legal Business Name | HEALTHWORKS HOME MEDICAL, INC.
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1895 COUNTY ROAD C W
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City | ROSEVILLE
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State | MN
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Zip | 55113-1304
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Country | US
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Telephone | 612-617-9562
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Fax |
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Provider Business Mailing Address
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Address Line | 1895 COUNTY ROAD C W
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City | ROSEVILLE
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State | MN
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Zip | 55113-1304
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Country | US
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Telephone | 612-617-9562
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MAUREEN NEWVILLE
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Credential |
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Telephone | 612-617-9562
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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 | 2821451
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License Number State | MN
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