MEDICARE: INVER WOOD HEALTHCARE CENTER 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	314000000X	Skilled Nursing Facility	327791	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7280185	OTHER	MN	MEDICA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	NH0109	OTHER	MN	UCARE
4	8743WE	OTHER	MN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1558359042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INVER WOOD HEALTHCARE CENTER INC

Provider Business Mailing Address
First Line	:	2060 UPPER 55TH ST E
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-1725
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 UPPER 55TH ST E
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-1725
Country	:	US
Telephone Number	:	651-451-1881
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOWIE GROFF
Credential	:
Telephone Number	:	952-888-2923

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	10/15/2008

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