Ivyrose LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

IVYROSE LLC

Practice address

1219 13TH Ave E
Hibbing, MN 55746-1217

Phone

(218) 969-6968

Fax

(218) 231-2082

NPI assigned

Jan 14, 2010

Organization subpart

No

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

Authorized official

Name

Mr. David Robert Popilek

Title

Owner/Pca

Phone

(218) 969-6968

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1821329871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 13TH AVE E",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557461217",
            "telephone_number": "218-969-6968",
            "fax_number": "218-231-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 13TH AVE E",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557461217",
            "telephone_number": "218-969-6968",
            "fax_number": "218-231-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYROSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "POPILEK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PCA",
        "authorized_official_telephone_number": "218-969-6968",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.