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General NPI Number Information
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NPI Number | 1265410633
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Entity Type | Organization
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Legal Business Name | ARCHBOLD HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 400 OLD ALBANY ROAD
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City | THOMASVILLE
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State | GA
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Zip | 31792-4013
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Country | US
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Telephone | 229-228-2200
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Fax | 229-228-2290
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Provider Business Mailing Address
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Address Line | P.O. BOX 620
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City | THOMASVILLE
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State | GA
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Zip | 31799-0620
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Country | US
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Telephone | 229-228-2200
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Fax | 229-228-2290
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOHN PERRY MUSTIAN
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Credential |
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Telephone | 229-228-2042
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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 | 20143096
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 136037
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License Number State | GA
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