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General NPI Number Information
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NPI Number | 1053440461
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Entity Type | Organization
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Legal Business Name | HOME CARE MEDICAL SYSTEMS
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 259 S. RANDOLPH AVE. #180 K
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City | BREA
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State | CA
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Zip | 92821
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Country | US
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Telephone | 714-671-6877
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Fax | 714-671-6801
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Provider Business Mailing Address
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Address Line | PO BOX 11063
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City | BREA
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State | CA
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Zip | 92821
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Country | US
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Telephone | 714-671-6877
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Fax | 714-671-6801
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | MS. JEANNINE A FITZGERALD
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Credential | RN, BA, MA
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Telephone | 626-445-6558
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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 | 980000776
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License Number State | CO
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