MEDICARE: NORTH WOODS HOME NURSING

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	251G00000X	Community Based Hospice Care Agency	11921	MI
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OE856	OTHER	MI	BCBS HOME HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659379097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH WOODS HOME NURSING

Provider Business Mailing Address
First Line	:	PO BOX 307
Second Line	:
City	:	MANISTIQUE
State	:	MI
Zip	:	49854-0307
Country	:	US
Telephone Number	:	906-341-6963
Fax Number	:	906-341-2490

Provider Business Practice Location Address
First Line	:	226 S CEDAR ST
Second Line	:
City	:	MANISTIQUE
State	:	MI
Zip	:	49854-1426
Country	:	US
Telephone Number	:	906-341-6963
Fax Number	:	906-341-2490

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CALEB VARONI
Credential	:
Telephone Number	:	800-852-3736

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/09/2022

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Directions to “NORTH WOODS HOME NURSING ” Practice Location

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