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NPI 1568068120

NPI 1568068120 : SWB FAMILY HOME HEALTH CARE, LLC : SAINT LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1568068120
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    Entity Type          |    Organization 
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    Legal Business Name  |    SWB FAMILY HOME HEALTH CARE, LLC 
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Dates
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    Enumeration Date     |    12/09/2020
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    Last Update Date     |    12/09/2020
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Provider Practice Location Address
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    Address Line         |    4144 LINDELL BLVD STE 326 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63108-2953
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    Country              |    US
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    Telephone            |    314-443-2891
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    Fax                  |    314-395-9079
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Provider Business Mailing Address
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    Address Line         |    4144 LINDELL BLVD STE 326 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63108-2953
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    Country              |    US
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    Telephone            |    314-443-2891
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    Fax                  |    314-395-9079
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Authorized Official
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    Title or Position    |    OWNER/DIRECTOR
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    Name                 |     MICHAEL  WRIGHT 
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    Credential           |    
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    Telephone            |    314-443-2891
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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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