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General NPI Number Information
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NPI Number | 1437579000
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Entity Type | Organization
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Legal Business Name | ICARE LLC
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 969 US HIGHWAY 80 W
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City | DEMOPOLIS
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State | AL
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Zip | 36732-4102
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Country | US
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Telephone | 334-289-9524
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Fax |
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Provider Business Mailing Address
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Address Line | 2539 JOHN HAWKINS PKWY STE 101-218
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City | HOOVER
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State | AL
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Zip | 35244-3555
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Country | US
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Telephone | 205-983-2628
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Fax |
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Authorized Official
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Title or Position | CEO/DOCTOR
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Name | DR. NATHAN E PARVIN
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Credential | OD
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Telephone | 205-393-1587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | SA83TA662
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License Number State | AL
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