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General NPI Number Information
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NPI Number | 1407926215
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Entity Type | Organization
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Legal Business Name | MOUNTAIN HEALTHCARE INC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 29099 HOSPITAL RD STE 101
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352
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Country | US
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Telephone | 909-337-0747
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Fax | 909-337-9195
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Provider Business Mailing Address
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Address Line | PO BOX 2527
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352-2527
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Country | US
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Telephone | 909-337-0747
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Fax | 909-337-9195
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINE PATEL
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Credential |
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Telephone | 909-337-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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