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General NPI Number Information
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NPI Number | 1487461539
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Entity Type | Organization
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Legal Business Name | HOMECARE HOME HEMODIALYSIS, PLLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 6121 N 52ND PL
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-5105
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Country | US
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Telephone | 480-578-3426
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Fax |
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Provider Business Mailing Address
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Address Line | 17677 W COUNTRY CLUB TER
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City | SURPRISE
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State | AZ
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Zip | 85387-4026
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Country | US
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Telephone | 480-578-4536
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MS. LEA HOLMAN
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Credential | CCHT
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Telephone | 480-578-4536
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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