Caremark Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CAREMARK HOME HEALTH CARE LLC

Practice address

720 E Lake St # 100
Minneapolis, MN 55407-1547

Phone

(612) 399-9987

Fax

(952) 487-4284

NPI assigned

Apr 22, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Idris O Abdi

Title

Administrator

Phone

(612) 399-9987

Specialties & licenses 1

Addresses

Other names 1

• CAREMARK HOME HEALTH CARE LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 248162

Legal name

CAREMARK HOME HEALTH CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 18, 2023

Last certification

Feb 9, 2023

Organization structure

LLCProprietary

Incorporated

May 24, 2019 in MN

Enrollment address

720 E Lake St
Ste 100
Minneapolis, MN 55407-1547

Listed as

Caremark Home Health Care LLCCCN 248162

Ownership

-

Certified

Feb 18, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1407476252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E LAKE ST # 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071547",
            "telephone_number": "612-501-1346",
            "fax_number": "952-487-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E LAKE ST # 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071547",
            "telephone_number": "612-399-9987",
            "fax_number": "952-487-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMARK HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "ABDI",
        "authorized_official_first_name": "IDRIS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-399-9987"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAREMARK HOME HEALTH CARE LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAREMARK HOME HEALTH CARE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.