MEDICARE: SAMAH SUPPORT SERVICES LLC

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	:	1356204655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMAH SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	2320 HIGHWAY 12 E STE 6A
Second Line	:
City	:	WILLMAR
State	:	MN
Zip	:	56201-5811
Country	:	US
Telephone Number	:	320-349-8828
Fax Number	:	320-205-0525

Provider Business Practice Location Address
First Line	:	2320 HIGHWAY 12 E STE 6A
Second Line	:
City	:	WILLMAR
State	:	MN
Zip	:	56201-5811
Country	:	US
Telephone Number	:	320-349-8828
Fax Number	:	320-205-0525

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISMAHAN HASSAN OSMAN
Credential	:
Telephone Number	:	320-349-8828

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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Directions to “SAMAH SUPPORT SERVICES LLC ” Practice Location

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