Provider Demographics
NPI:1205367430
Name:SWIFT HOME HEALTHCARE
Entity Type:Organization
Organization Name:SWIFT HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRIZAK
Authorized Official - Middle Name:MAHDI
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-310-0348
Mailing Address - Street 1:7160 CAHILL RD
Mailing Address - Street 2:APT 230
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2046
Mailing Address - Country:US
Mailing Address - Phone:612-310-0348
Mailing Address - Fax:
Practice Address - Street 1:7160 CAHILL RD
Practice Address - Street 2:APT 230
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2046
Practice Address - Country:US
Practice Address - Phone:612-310-0348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN939290000026251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health