MEDICARE: NGUFOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	28144	MN

General Provider Information

NPI Number	:	1013297027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGUFOR

Provider Business Mailing Address
First Line	:	6500 BROOKLYN BLVD
Second Line	:	SUITE 108
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-1754
Country	:	US
Telephone Number	:	651-329-6478
Fax Number	:	763-205-5899

Provider Business Practice Location Address
First Line	:	6500 BROOKLYN BLVD
Second Line	:	SUITE 108
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-1754
Country	:	US
Telephone Number	:	651-329-6478
Fax Number	:	763-205-5899

Authorized Official
Title or Position	:	OWNER (ADMINISTRATOR)
Name	:	PATRICK AZEH NGUFOR
Credential	:	MBA
Telephone Number	:	651-329-6478

Provider Enumeration Date	:	08/22/2011
Last Update Date	:	08/22/2011

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Directions to “NGUFOR ” Practice Location

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