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General NPI Number Information
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NPI Number | 1245415389
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FAMILY HEALTH CARE LLC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 142 S WINCHESTER ST
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City | BENTON
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State | MO
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Zip | 63736-0000
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Country | US
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Telephone | 573-335-1344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1396
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63702-1396
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Country | US
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Telephone | 573-335-1344
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Fax | 573-335-3992
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROBIN E. MILLER
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Credential |
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Telephone | 573-561-4814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 100630
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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