Provider Demographics
NPI:1730500612
Name:SAMAWADE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SAMAWADE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SALAD
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-876-0814
Mailing Address - Street 1:810 4TH AVE S # 6560
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2800
Mailing Address - Country:US
Mailing Address - Phone:218-284-8021
Mailing Address - Fax:
Practice Address - Street 1:810 4TH AVE S # 6560
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2800
Practice Address - Country:US
Practice Address - Phone:218-284-8021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health