MEDICARE: BANADIR HOME HEALTH CARE 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	:	1548717911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANADIR HOME HEALTH CARE LLC.

Provider Business Mailing Address
First Line	:	2817 ANTHONY LN S STE 201
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-2490
Country	:	US
Telephone Number	:	612-598-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 ANTHONY LN S STE 201
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-2490
Country	:	US
Telephone Number	:	612-598-3333
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. AHMED SAID
Credential	:
Telephone Number	:	612-598-3333

Provider Enumeration Date	:	09/02/2016
Last Update Date	:	09/02/2016

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