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General NPI Number Information
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NPI Number | 1205740925
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Entity Type | Organization
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Legal Business Name | AGYAMAN, LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 2732 N CHATHAM CT
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City | WINTERVILLE
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State | NC
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Zip | 28590-7915
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Country | US
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Telephone | 910-617-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 2732 N CHATHAM CT
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City | WINTERVILLE
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State | NC
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Zip | 28590-7915
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOCELYN FONG
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Credential |
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Telephone | 910-617-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State | NULL
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