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General NPI Number Information
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NPI Number | 1255599189
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Entity Type | Organization
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Legal Business Name | CMC HOME HEALTH AND HOSPICE, LLC
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 130 PARTEE RD
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City | CALICO ROCK
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State | AR
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Zip | 72519-6032
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Country | US
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Telephone | 870-297-3738
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Fax | 870-297-3739
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-233-5764
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L PROFFITT
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Credential |
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Telephone | 337-233-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AR40470
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License Number State | AR
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