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General NPI Number Information
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NPI Number | 1104807841
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Entity Type | Organization
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Legal Business Name | HOME CONVALESCENT AIDS, INC.
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 1113 W LEXINGTON AVE
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City | WINCHESTER
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State | KY
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Zip | 40391-1169
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Country | US
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Telephone | 859-745-4445
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Fax | 859-745-0483
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Provider Business Mailing Address
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Address Line | 1113 W LEXINGTON AVE
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City | WINCHESTER
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State | KY
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Zip | 40391-1169
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Country | US
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Telephone | 859-745-4445
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Fax | 859-745-0483
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST
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Name | MR. DONALD KENNETH DOVE
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Credential | RPH
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Telephone | 859-745-4445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P01493
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License Number State | KY
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