MEDICARE: NE DINNERBELL MEALS ON WHEELS

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	251V00000X	Voluntary or Charitable Agency	126620100	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	126620100	OTHER	MN	UMPI

General Provider Information

NPI Number	:	1780843755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NE DINNERBELL MEALS ON WHEELS

Provider Business Mailing Address
First Line	:	2511 TAYLOR ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418
Country	:	US
Telephone Number	:	612-789-6548
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 TAYLOR ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3731
Country	:	US
Telephone Number	:	612-623-3363
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	EILEEN HAFFTEN
Credential	:
Telephone Number	:	612-623-3363

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	10/30/2009

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