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General NPI Number Information
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NPI Number | 1306152020
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN MEDICAL CASE MANAGEMENT & REHAB SERVICES, INC
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 08/19/2010
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Provider Practice Location Address
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Address Line | 1 TOWN SQUARE BLVD SUITE 263
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City | ASHEVILLE
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State | NC
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Zip | 28803-5006
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Country | US
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Telephone | 828-505-7550
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Fax | 828-505-2380
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Provider Business Mailing Address
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Address Line | 1 TOWN SQUARE BLVD SUITE 263
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City | ASHEVILLE
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State | NC
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Zip | 28803-5006
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Country | US
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Telephone | 828-505-7550
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Fax | 828-505-2380
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. WILLIAM JONATHAN EATON SR.
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Credential | RN, CCM, CNLCP
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Telephone | 82855057550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 151506
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License Number State | NC
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