TRISTAR HOME CARE LLC (NPI# 1649779828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649779828 |
| Entity Type | Organization |
| Organization Name | TRISTAR HOME CARE LLC |
| Practice Address |
9402 93rd St S Cottage Grove MN 55016-4096 |
| Practice Telephone | 7634155471 |
| Practice Fax Number | 7632048141 |
| Mailing Telephone | 7634155471 |
| Mailing Fax Number | 7632048141 |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2019-09-19 |
| Authorized Official Name | MR. RAPHAEL OZURUMBA (ADMINISTRATOR) |
| Authorized Official Telephone | 6513366815 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| Y | 251E00000X | Home Health | 385032 | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | COMPREHENSIVE HOME CARE LICENSE | 385032 | 01 |
| MN | COMPREHENSIVE HOME CARE LICENSE | 1649779828 | 01 |
| Street Address |
9402 93RD ST S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016-4096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
| 1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
| 1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
| 1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346860137 | Rightchoice Health Care Services LLC | Home Health | 9455 Jarrod Ave S, Cottage Grove, MN 55016-5004 | 2020-04-21 |
| 1831665884 | Masirey Home Care LLC | Home Health | 213 W Cottage Grove Rd Ste G9, Cottage Grove, WI 53527-9327 | 2018-10-17 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1679839609 | Inspired Care Services Inc. | Home Health | 6620 Wildflower Dr S, Cottage Grove, MN 55016-1730 | 2012-04-03 |
| 1104026988 | King David Home Health Care Services LLC | Home Health | 7758 Janero Court South, Cottage Grove, MN 55016 | 2007-07-20 |
| 1497953236 | King David Home Health Care | Home Health | 7758 Janero Ct, Cottage Grove, MN 55016-2217 | 2007-07-03 |
| 1578520755 | Levcar Enterprises, LLC | Home Health | 7323 Jorgensen Ave S, Cottage Grove, MN 55016-3652 | 2006-04-29 |
| 1558832105 | Amerigrace Home Care LLC | Home Health | 9633 Hale Ave S, Cottage Grove, MN 55016-3894 | 2018-12-07 |
| 1588832216 | King David Home Health Care Services | Home Health | 7758 Janero Ct, Cottage Grove, MN 55016-2217 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770399 | Tender Care Providers LLC | Home Health | 1794 Switchgrass Cir, Shakopee, MN 55379-8533 | 2020-11-07 |
| 1194326942 | Shakur Abdisalam | Home Health | 1440 E Old Shakopee Rd, Bloomington, MN 55425-2438 | 2020-11-06 |
| 1821699182 | Immediate Home Health Care LLC | Home Health | 2817 Anthony Ln S Ste 210, St Anthony, MN 55418-2488 | 2020-11-03 |
| 1093315780 | Eco Green Corporation | Home Health | 3274 98th Cir N, Brooklyn Park, MN 55443-1846 | 2020-10-30 |
| 1841899846 | Hands On Care | Home Health | 1550 Larpenteur Ave W Apt 423, Falcon Heights, MN 55113-6364 | 2020-10-21 |
| 1326646191 | Rose Pratt | Home Health | 121 83rd Ave Ne Apt 310, Fridley, MN 55432-1893 | 2020-10-14 |
| 1255939369 | Mn Health LLC | Home Health | 784 Cougar Dr, Eagan, MN 55123-2069 | 2020-10-12 |
| 1942807672 | Twin Cities Group Homes LLC | Home Health | 711 22nd Ave Ne, Minneapolis, MN 55418-3601 | 2020-10-06 |
| 1801493721 | Shifaa Care Inc | Home Health | 7038 Brooklyn Blvd Unit D, Brooklyn Center, MN 55429-1370 | 2020-10-04 |
| 1841807450 | Shire Homecare Agency | Home Health | 618 9th Ave S Apt 307, Minneapolis, MN 55415-4608 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.