Provider Demographics
NPI:1639468689
Name:HODMAN HOME HEALTH CARE SERVICE
Entity Type:Organization
Organization Name:HODMAN HOME HEALTH CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-398-9573
Mailing Address - Street 1:1492 SUNSET AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4302
Mailing Address - Country:US
Mailing Address - Phone:507-398-9573
Mailing Address - Fax:
Practice Address - Street 1:1492 SUNSET AVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4302
Practice Address - Country:US
Practice Address - Phone:507-398-9573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health