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General NPI Number Information
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NPI Number | 1104201789
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Entity Type | Organization
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Legal Business Name | HEALTH CARE MEDICAL
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Dates
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Enumeration Date | 07/24/2015
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 625 S PEAR ORCHARD RD SUITE A
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City | RIDGELAND
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State | MS
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Zip | 39157-4836
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Country | US
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Telephone | 601-420-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 625 S PEAR ORCHARD RD SUITE A
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City | RIDGELAND
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State | MS
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Zip | 39157-4836
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VALERIE HARDEN
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Credential |
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Telephone | 601-420-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 05882/2.5
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License Number State | MS
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