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General NPI Number Information
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NPI Number | 1124365184
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Entity Type | Organization
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Legal Business Name | AVON HOSPICE CARE, INC.
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 9007 ARROW RTE STE 180
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4459
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Country | US
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Telephone | 909-833-7579
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Fax | 909-833-7580
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Provider Business Mailing Address
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Address Line | 9007 ARROW RTE STE 180
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4459
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Country | US
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Telephone | 909-481-7579
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Fax | 909-833-7576
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Authorized Official
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Title or Position | CEO
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Name | MS. LULU AQUINO
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Credential |
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Telephone | 909-481-7579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 550002342
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License Number State | CA
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