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General NPI Number Information
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NPI Number | 1194820613
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Entity Type | Organization
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Legal Business Name | HOMESTEAD MEDICAL EQUIPMENT & SUPPLIES, INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1457 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4208
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Country | US
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Telephone | 305-242-4129
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Fax |
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Provider Business Mailing Address
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Address Line | 1457 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4208
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Country | US
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Telephone | 305-242-4129
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VIVIAN CASTILLO
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Credential |
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Telephone | 305-242-4129
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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 | 1312012
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 3203601
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 22568
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License Number State | FL
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