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General NPI Number Information
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NPI Number | 1326510652
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Entity Type | Organization
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Legal Business Name | PRIME HEALTH LLC
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 3616 S BOGAN RD STE 202
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City | BUFORD
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State | GA
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Zip | 30519-4310
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Country | US
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Telephone | 678-288-9740
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Fax | 678-288-9779
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Provider Business Mailing Address
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Address Line | 3616 S BOGAN RD STE 202
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City | BUFORD
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State | GA
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Zip | 30519-4310
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Country | US
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Telephone | 678-288-9740
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Fax | 678-288-9779
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | DR. BUNMI Y FOLARINDE
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Credential | PHD, FNP, CME
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Telephone | 404-333-7652
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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 |
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License Number State |
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