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General NPI Number Information
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NPI Number | 1114048675
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Entity Type | Organization
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Legal Business Name | HARBORSIDE REHABILITATION LP
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 2602 HIGHLANDS BLVD N
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City | PALM HARBOR
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State | FL
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Zip | 34684-2114
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Country | US
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Telephone | 800-276-4556
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Fax | 727-786-6265
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Provider Business Mailing Address
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Address Line | 2602 HIGHLANDS BLVD N
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City | PALM HARBOR
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State | FL
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Zip | 34684-2114
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Country | US
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Telephone | 800-276-4556
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Fax | 727-786-6265
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES EDWARD COCKE
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Credential |
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Telephone | 800-276-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | TZ9G
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | NPA00019
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 611
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License Number State | FL
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