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General NPI Number Information
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NPI Number | 1497895171
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Entity Type | Organization
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Legal Business Name | MAXMED HEALTHCARE, INC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 506 E RAMSEY RD SUITE 1
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4657
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Country | US
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Telephone | 210-599-3233
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Fax | 210-579-6654
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Provider Business Mailing Address
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Address Line | PO BOX 592240
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City | SAN ANTONIO
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State | TX
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Zip | 78259-0161
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Country | US
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Telephone | 210-599-3233
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Fax | 210-579-6654
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. OLUSEGUN OYEWOLE
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Credential |
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Telephone | 210-979-7805
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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 | 008735
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License Number State | TX
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