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General NPI Number Information
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NPI Number | 1083982813
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Entity Type | Organization
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Legal Business Name | RADIANT HOME HEALTHCARE
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 1536 SCENIC VALLEY PL
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City | LANCASTER
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State | OH
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Zip | 43130-8470
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Country | US
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Telephone | 740-777-1636
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 SCENIC VALLEY PL
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City | LANCASTER
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State | OH
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Zip | 43130-8470
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Country | US
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Telephone | 740-777-1636
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MR. MARTIN C DURU
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Credential | REGISTERED NURSE
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Telephone | 740-973-4370
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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 | 201133400614
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License Number State | OH
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