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General NPI Number Information
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NPI Number | 1467636209
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Entity Type | Organization
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Legal Business Name | MOBILE RESPIRATORY&ANCILLARY SERVICE LLC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 13011 W. M C N ICHOLS
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City | DETROIT
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State | MI
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Zip | 48235-4106
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Country | US
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Telephone | 313-862-2094
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Fax | 313-491-0041
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Provider Business Mailing Address
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Address Line | 13011 W. M C N ICHOLS
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City | DETROIT
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State | MI
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Zip | 48235-4106
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Country | US
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Telephone | 313-926-1526
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Fax | 313-491-0041
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL JOHNSON
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Credential |
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Telephone | 313-926-1526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 332B00000X
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License Number State | MI
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