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1104788124 NPI number — OIOBOW HEALTHCARE, LLC

NPI Number: 1104788124
Health Care Provider/Practitioner: OIOBOW HEALTHCARE, LLC

Information about “1104788124” NPI (OIOBOW HEALTHCARE, LLC) exists in 1104788124 in HTML format HTML  |  1104788124 in plain Text format TXT  |  1104788124 in PDF (Portable Document Format) PDF  |  1104788124 in an XML format XML  formats.

NPI Number : 1104788124 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104788124",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OIOBOW HEALTHCARE, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5091 E JACKSON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MUNCIE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47303-4486",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "765-468-6337",
    "MailingAddressFaxNumber": "765-896-8186",
    "FirstLinePracticeLocationAddress": "5091 E JACKSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MUNCIE",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47303-4486",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "765-468-6337",
    "PracticeLocationAddressFaxNumber": "765-896-8186",
    "EnumerationDate": "11/28/2025",
    "LastUpdateDate": "11/28/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BOW",
    "AuthorizedOfficialFirstName": "CURTIS",
    "AuthorizedOfficialMiddleName": "OLIVER",
    "AuthorizedOfficialTitle": "MEMBER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": "JR.",
    "AuthorizedOfficialCredential": "NP",
    "AuthorizedOfficialTelephoneNumber": "765-468-6337",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QI0500X",
          "TaxonomyName": "Infusion Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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