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NPI Code Detail

MEDICARE: MIDWEST PROFESSIONAL SERVICES, INC.

MEDICARE: MIDWEST PROFESSIONAL SERVICES, INC.
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
1251E00000XHome Health Agency24359MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
124359OTHERMNMN CLASS A LICENSE

General Provider Information

NPI Number : 1134176985
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWEST PROFESSIONAL SERVICES, INC.
Provider Business Mailing Address
First Line : 801 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-1136
Country : US
Telephone Number : 612-343-3265
Fax Number : 612-343-3267
Provider Business Practice Location Address
First Line : 801 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-1136
Country : US
Telephone Number : 612-343-3265
Fax Number : 612-343-3267
Authorized Official
Title or Position : ADMINISTRATOR/OWNER
Name : MOHAMUD HASSAN
Credential :
Telephone Number : 612-343-3265
Provider Enumeration Date : 05/27/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

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Practice Location Address:
801 PARK AVE
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1255663605 — MRS. TERESA J. WAGNER R.N.
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1972825040 — MRS. PAMELA L. ROCKLAGE R.N.
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1003164492 — RACHEL FOSS RN
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Directions to “MIDWEST PROFESSIONAL SERVICES, INC. ” Practice Location

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