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General NPI Number Information
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NPI Number | 1154700979
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Entity Type | Organization
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Legal Business Name | AMERICAN MEDICAL DISTRIBUTORS
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 05/26/2015
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Provider Practice Location Address
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Address Line | 24912 HARPER AVE 2
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1242
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Country | US
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Telephone | 586-775-6666
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36787
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City | GROSSE POINTE
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State | MI
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Zip | 48236-0787
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Country | US
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Telephone | 586-775-6666
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | CYNTHIA ROSE
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Credential |
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Telephone | 586-775-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MI
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