Provider Demographics
NPI:1578129342
Name:MIDWAY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:MIDWAY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAYING
Authorized Official - Middle Name:LOR
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-793-6901
Mailing Address - Street 1:1459 RICE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-3864
Mailing Address - Country:US
Mailing Address - Phone:651-793-6901
Mailing Address - Fax:651-776-5251
Practice Address - Street 1:1459 RICE ST STE 2
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-3864
Practice Address - Country:US
Practice Address - Phone:651-793-6901
Practice Address - Fax:651-776-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN170038OtherUCARE
MNR-125199-7OtherMHP
MN635-T4MIOtherBLUE CROSS BLUE SHIELD
MN1085005-2-HCBSMedicaid
MN49-80531OtherMEDICA
MN81215OtherHEALTHPARTNERS
MN1750461042Medicaid