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General NPI Number Information
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NPI Number | 1568467942
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Entity Type | Organization
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Legal Business Name | QUALITY HOME MEDICAL EQUIPMENT, LLC
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 524 E MAIN ST
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City | STROUD
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State | OK
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Zip | 74079-4217
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Country | US
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Telephone | 918-968-9226
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Fax | 918-968-2169
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Provider Business Mailing Address
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Address Line | 524 E MAIN ST
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City | STROUD
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State | OK
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Zip | 74079-4217
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Country | US
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Telephone | 918-968-9226
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Fax | 918-968-2169
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Authorized Official
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Title or Position | OWNER
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Name | MR. JACK LEROY STAFFORD JR.
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Credential |
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Telephone | 918-968-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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