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NPI 1174708309

NPI 1174708309 : CLARKE ELECTRIC COOPERATIVE, INC. : OSCEOLA, IA

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General NPI Number Information
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    NPI Number           |    1174708309
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    Entity Type          |    Organization 
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    Legal Business Name  |    CLARKE ELECTRIC COOPERATIVE, INC. 
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Dates
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    Enumeration Date     |    01/07/2008
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    Last Update Date     |    01/07/2008
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Provider Practice Location Address
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    Address Line         |    1103 N MAIN ST 
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    City                 |    OSCEOLA
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    State                |    IA
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    Zip                  |    50213-9321
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    Country              |    US
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    Telephone            |    641-342-2173
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    Fax                  |    641-342-6292
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Provider Business Mailing Address
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    Address Line         |    1103 N MAIN ST 
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    City                 |    OSCEOLA
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    State                |    IA
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    Zip                  |    50213-9321
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    Country              |    US
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    Telephone            |    641-342-2173
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    Fax                  |    641-342-6292
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Authorized Official
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    Title or Position    |    DIR, MEMBER SERVICES
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    Name                 |    MR. JASON A GIBBS 
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    Credential           |    
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    Telephone            |    641-342-2173
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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 |    
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