Provider Demographics
NPI:1205270899
Name:MIDWEST QUALITY HOME CARE INC
Entity type:Organization
Organization Name:MIDWEST QUALITY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAID
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-343-4004
Mailing Address - Street 1:1433 E FRANKLIN AVE
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2101
Mailing Address - Country:US
Mailing Address - Phone:612-343-4004
Mailing Address - Fax:612-343-4007
Practice Address - Street 1:1433 E FRANKLIN AVE
Practice Address - Street 2:SUITE # 1
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2101
Practice Address - Country:US
Practice Address - Phone:612-343-4004
Practice Address - Fax:612-343-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 214603-0251E00000X
MNR165007251E00000X
MNR205663251E00000X
MNR1764992251E00000X
MNR1752027251E00000X
MNR212457-3251E00000X
MNR199730-3251E00000X
MN219215-2251E00000X
MN215981-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN215981-0Other1114358009
MNR 214603-0OtherM477417200
MNR205663OtherA228117200
MNR165007OtherA188427300
MN1752027OtherM096428000
MN219215-2Other1265845275
MNR199730-3Other1578805479
MNR212457-3OtherA534643100
MN1922401363OtherRN
MNR1764992OtherA066612100