MEDICARE: JW ADVANTAGE 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		MN

General Provider Information

NPI Number	:	1568743474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JW ADVANTAGE CARE, LLC

Provider Business Mailing Address
First Line	:	1870- 50TH STREET E.
Second Line	:	SUITE 7
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077
Country	:	US
Telephone Number	:	651-330-3071
Fax Number	:	651-330-3721

Provider Business Practice Location Address
First Line	:	1870- 50TH STREET E.
Second Line	:	SUITE 7
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077
Country	:	US
Telephone Number	:	651-330-3071
Fax Number	:	651-330-3721

Authorized Official
Title or Position	:	OWNER
Name	:	JOAN M. WURZER
Credential	:
Telephone Number	:	651-330-3071

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	09/06/2011

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