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General NPI Number Information
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NPI Number | 1205917754
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Entity Type | Individual
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Provider Name | CONNIE M MASSOUD RPH
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE INPATIENT PHARMACY
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City | SACRAMENTO
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State | CA
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Zip | 95825-2115
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Country | US
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Telephone | 916-973-6349
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Fax | 916-973-7062
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Provider Business Mailing Address
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Address Line | 4238 RANDHURST WAY
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City | FAIR OAKS
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State | CA
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Zip | 95628-6256
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Country | US
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Telephone | 916-962-0937
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Fax |
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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 | RPH37837
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License Number State | CA
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