MEDICARE: HEALTHCARE OPTIONS OF MINNESOTA, 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	325320	MN
2	261QI0500X	Infusion Therapy Clinic/Center	262603-9	MN
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	262603-9	MN
4	3336S0011X	Specialty Pharmacy	262603-9	MN
5	3336H0001X	Home Infusion Therapy Pharmacy	262603-9	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	870000797	OTHER		MEDICARE B LOCAL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891746111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE OPTIONS OF MINNESOTA, INC.

Provider Business Mailing Address
First Line	:	4459 PAYSPHERE CIR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-0044
Country	:	US
Telephone Number	:	800-879-6137
Fax Number	:	847-913-9024

Provider Business Practice Location Address
First Line	:	1000 S BENTON DR
Second Line	:	SUITE 405
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-1228
Country	:	US
Telephone Number	:	320-252-5666
Fax Number	:	320-252-5073

Authorized Official
Title or Position	:	VICE PRESIDENT AND ASST. SECRETARY
Name	:	LORI ZSITEK
Credential	:
Telephone Number	:	800-879-6137

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/20/2012

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