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General NPI Number Information
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NPI Number | 1083982615
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Entity Type | Organization
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Legal Business Name | EMERGENT HEALTHCARE LLC
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 1604 E SANTA FE AVE SUITE 224
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City | GRANTS
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State | NM
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Zip | 87020-4006
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Country | US
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Telephone | 505-285-0757
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Fax | 505-216-2642
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Provider Business Mailing Address
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Address Line | 1604 E SANTA FE AVE SUITE 224
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City | GRANTS
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State | NM
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Zip | 87020-4006
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Country | US
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Telephone | 505-285-0757
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Fax | 505-216-2642
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Authorized Official
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Title or Position | BUSINESS DEVELOPMENT DIRECTOR
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Name | KAREN WALKER
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Credential | LPN, ASN
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Telephone | 505-285-0757
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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 |
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License Number State |
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