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General NPI Number Information
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NPI Number | 1548088503
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Entity Type | Organization
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Legal Business Name | USA HEALTH COMMUNITY PROVIDERS LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 2505 OLD SHELL RD
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City | MOBILE
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State | AL
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Zip | 36607-3021
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Country | US
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Telephone | 251-341-4094
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36528
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City | BELFAST
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State | ME
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Zip | 04915
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BENNY JOSEPH STOVER
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Credential |
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Telephone | 251-445-9164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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