MEDICARE: TC HOME HEALTH CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1629443239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TC HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	2817 ANTHONY LN S STE 200
Second Line	:
City	:	SAINT ANTHONY
State	:	MN
Zip	:	55418-2490
Country	:	US
Telephone Number	:	612-810-9887
Fax Number	:	612-721-1900

Provider Business Practice Location Address
First Line	:	2817 ANTHONY LN S STE 200
Second Line	:
City	:	SAINT ANTHONY
State	:	MN
Zip	:	55418-2490
Country	:	US
Telephone Number	:	612-810-9887
Fax Number	:	612-721-1900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FADUMA OMAR DAKANE
Credential	:
Telephone Number	:	612-810-9887

Provider Enumeration Date	:	12/08/2015
Last Update Date	:	12/08/2015

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Directions to “TC HOME HEALTH CARE INC ” Practice Location

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