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General NPI Number Information
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NPI Number | 1174869176
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Entity Type | Organization
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Legal Business Name | EOS MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 29 S NEW YORK RD SUITE 900
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City | GALLOWAY
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State | NJ
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Zip | 08205
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Country | US
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Telephone | 215-453-8367
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Fax | 610-200-5322
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Provider Business Mailing Address
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Address Line | 29 S NEW YORK RD SUITE 900
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City | GALLOWAY
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State | NJ
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Zip | 08205
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Country | US
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Telephone | 215-453-8367
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Fax | 610-200-5322
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | MRS. DANA A DENNER
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Credential |
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Telephone | 215-453-8367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 85648139
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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