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NPI 1568013746

NPI 1568013746 : ARBOR MEDICAL SUPPLIES : LISLE, IL

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General NPI Number Information
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    NPI Number           |    1568013746
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    Entity Type          |    Organization 
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    Legal Business Name  |    ARBOR MEDICAL SUPPLIES 
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Dates
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    Enumeration Date     |    09/27/2019
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    Last Update Date     |    09/27/2019
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Provider Practice Location Address
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    Address Line         |    4533 ARBOR VIEW DR 
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    City                 |    LISLE
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    State                |    IL
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    Zip                  |    60532-1362
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    Country              |    US
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    Telephone            |    630-664-5259
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4533 ARBOR VIEW DR 
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    City                 |    LISLE
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    State                |    IL
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    Zip                  |    60532-1362
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    Country              |    US
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    Telephone            |    630-664-5259
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. ENEFIOK  EKONG 
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    Credential           |    
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    Telephone            |    630-664-5259
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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       |    
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    License Number State |    
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