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General NPI Number Information
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NPI Number | 1053312033
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Entity Type | Organization
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Legal Business Name | ODYSSEY HEALTHCARE OPERATING A LP
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 301 E VANDERBILT WAY STE 250
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3512
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Country | US
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Telephone | 909-888-5000
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Fax | 909-888-4040
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Provider Business Mailing Address
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Address Line | PO BOX 4060 ATTN REGULATORY
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City | MOORESVILLE
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State | NC
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Zip | 28117-4060
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Country | US
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Telephone | 704-664-2876
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Fax | 704-664-1306
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Authorized Official
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Title or Position | VP OF LICENSURE
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Name | JANET L. COMBS
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Credential |
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Telephone | 704-664-2876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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