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General NPI Number Information
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NPI Number | 1588877583
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Entity Type | Organization
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Legal Business Name | SUMMIT HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 800 BOONE AVE N SUITE 175
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-4468
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Country | US
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Telephone | 763-546-8477
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Fax | 763-417-9999
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Provider Business Mailing Address
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Address Line | 800 BOONE AVE N SUITE 175
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-4468
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Country | US
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Telephone | 763-546-8477
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Fax | 763-417-9999
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MARK OLSHANSKY
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Credential |
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Telephone | 763-546-8477
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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 | 335895
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License Number State | MN
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