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General NPI Number Information
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NPI Number | 1235171687
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Entity Type | Organization
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Legal Business Name | PULMOCAIR RESPIRATORY, INC,
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 82 SPRUCE ST SUITE 121
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City | MURRAY
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State | KY
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Zip | 42071-2150
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Country | US
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Telephone | 270-767-1519
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Fax | 866-233-9219
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Provider Business Mailing Address
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Address Line | 755 NW 17TH AVE SUITE 106
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2522
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Country | US
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Telephone | 561-274-9664
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Fax | 561-274-7000
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JONATHAN FEDELE
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Credential |
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Telephone | 561-274-9664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07095
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License Number State | KY
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