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General NPI Number Information
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NPI Number | 1285092031
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MEDICAL HOME CARE, LLC
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 112 WESTFIELD ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-2577
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Country | US
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Telephone | 413-301-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WESTFIELD ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-2577
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Country | US
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Telephone | 413-301-5353
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. DONNA MARIE BYS
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Credential | EDD,MSN,MPA,RN,LNHA
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Telephone | 413-301-5353
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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 |
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License Number State | MA
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