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NPI 1205324712

NPI 1205324712 : BRENDA KAYE ARMENTROUT RPH : LAGRANGE, IN

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General NPI Number Information
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    NPI Number           |    1205324712
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    Entity Type          |    Individual 
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    Provider Name        |    BRENDA KAYE ARMENTROUT RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/30/2018
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    Last Update Date     |    04/30/2018
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Provider Practice Location Address
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    Address Line         |    207 N TOWNLINE RD 
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    City                 |    LAGRANGE
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    State                |    IN
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    Zip                  |    46761-1325
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    Country              |    US
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    Telephone            |    260-463-9370
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    Fax                  |    260-463-9457
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Provider Business Mailing Address
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    Address Line         |    207 N TOWNLINE RD 
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    City                 |    LAGRANGE
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    State                |    IN
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    Zip                  |    46761-1325
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    Country              |    US
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    Telephone            |    260-463-9370
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    Fax                  |    260-463-9457
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    26013718A
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    License Number State |    IN
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