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NPI 1023765369

NPI 1023765369 : PRIME HOME HEALTHCARE SERVICES CORPORATION : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1023765369
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    Entity Type          |    Organization 
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    Legal Business Name  |    PRIME HOME HEALTHCARE SERVICES CORPORATION 
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Dates
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    Enumeration Date     |    03/07/2022
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    Last Update Date     |    03/07/2022
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Provider Practice Location Address
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    Address Line         |    7238 N BELL AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60645-2004
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    Country              |    US
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    Telephone            |    312-690-9087
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7238 N BELL AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60645-2004
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    Country              |    US
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    Telephone            |    312-690-9087
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     SOLOMON  BADA 
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    Credential           |    
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    Telephone            |    312-690-9087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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