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General NPI Number Information
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NPI Number | 1124270228
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Entity Type | Organization
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Legal Business Name | HOME MEDICAL SUPPLIES AND PHARMACY
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 711 DEVON AVE 203
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City | PARK RIDGE
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State | IL
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Zip | 60068-4713
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Country | US
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Telephone | 847-292-9984
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Fax | 847-292-9986
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Provider Business Mailing Address
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Address Line | 711 DEVON AVE 203
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City | PARK RIDGE
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State | IL
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Zip | 60068-4713
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Country | US
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Telephone | 847-292-9984
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Fax | 847-292-9986
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Authorized Official
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Title or Position | PRESIDENT
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Name | JIGNESH GANDHI
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Credential |
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Telephone | 630-660-1709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054-16537
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License Number State | IL
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