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NPI 1578589347

NPI 1578589347 : SCOOTER STORE DES MOINES LLC : URBANDALE, IA

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General NPI Number Information
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    NPI Number           |    1578589347
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    Entity Type          |    Organization 
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    Legal Business Name  |    SCOOTER STORE DES MOINES LLC 
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Dates
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    Enumeration Date     |    07/14/2006
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    Last Update Date     |    08/02/2013
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Provider Practice Location Address
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    Address Line         |    3057 99TH ST 
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    City                 |    URBANDALE
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    State                |    IA
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    Zip                  |    50322-3895
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    Country              |    US
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    Telephone            |    515-270-0570
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 310709 
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    City                 |    NEW BRAUNFELS
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    State                |    TX
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    Zip                  |    78131-0709
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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    |    GENERAL COUNSEL & SECRETARY
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    Name                 |     JASON  CONE 
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    Credential           |    
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    Telephone            |    830-627-4433
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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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