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General NPI Number Information
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NPI Number | 1053356766
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Entity Type | Organization
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Legal Business Name | MODERN HEALTHCARE SERVICES
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 10440 E NORTHWEST HWY SUITE #300
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City | DALLAS
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State | TX
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Zip | 75238-4608
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Country | US
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Telephone | 972-222-1880
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Fax | 972-686-0786
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Provider Business Mailing Address
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Address Line | 10440 E. NORTHWEST HWY. SUITE #300
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 972-222-1880
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Fax | 972-686-0786
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Authorized Official
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Title or Position | CEO
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Name | MR. LYNN D. TRIMBLE
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Credential |
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Telephone | 469-471-5158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 014030
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License Number State | TX
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