MEDICARE: CW HEALTHCARE 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	332BC3200X	Customized Equipment (DME)	2823896	MN
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	2823896	MN
3	335E00000X	Prosthetic/Orthotic Supplier	2823896	MN
4	332B00000X	Durable Medical Equipment & Medical Supplies	2823896	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4998452	OTHER	SD	BLUE CROSS OF SO DAKOTA
3	108381	OTHER	MN	UCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	7033429	OTHER	MN	PREFERRED ONE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	54-0-E2-03040	OTHER	MI	BLUE CROSS OF MICHIGAN
9	2G671CW	OTHER	MN	BLUE CROSS BLUE SHIELD MN
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629066576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CW HEALTHCARE INC

Provider Business Mailing Address
First Line	:	80 LITTLE CANADA RD E STE 4
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-1343
Country	:	US
Telephone Number	:	952-426-4812
Fax Number	:	952-658-6853

Provider Business Practice Location Address
First Line	:	80 LITTLE CANADA RD E STE 4
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-1343
Country	:	US
Telephone Number	:	952-426-4812
Fax Number	:	952-658-6853

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW REINHARDT
Credential	:
Telephone Number	:	612-300-7747

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	09/21/2021

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