MEDICARE: MERCY HOME HEALTH CARE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1154725414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	3408 SNELLING AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2638
Country	:	US
Telephone Number	:	612-323-1727
Fax Number	:

Provider Business Practice Location Address
First Line	:	3538 NEBRASKA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-3706
Country	:	US
Telephone Number	:	612-323-1727
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMA HASSAN KHALIF
Credential	:
Telephone Number	:	612-323-1727

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/16/2014

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Directions to “MERCY HOME HEALTH CARE INC ” Practice Location

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