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General NPI Number Information
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NPI Number | 1346485588
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Entity Type | Organization
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Legal Business Name | TEAM CARE LLC
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 212 W JACKSON ST
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City | DUBLIN
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State | GA
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Zip | 31021-6100
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Country | US
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Telephone | 478-275-8176
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Fax | 478-275-8178
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Provider Business Mailing Address
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Address Line | 212 W JACKSON ST
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City | DUBLIN
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State | GA
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Zip | 31021-6100
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Country | US
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Telephone | 478-275-8176
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Fax | 478-275-8178
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Authorized Official
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Title or Position | OWNER / MGR
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Name | MR. WILLIAM AUSTIN FROST SR.
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Credential |
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Telephone | 478-275-8176
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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 | 087-R-0007
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License Number State | GA
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