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General NPI Number Information
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NPI Number | 1588954804
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Entity Type | Individual
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Provider Name | MRS. PHYLLIS MAAME AFFUL
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Gender | Female
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 23709 CENTER RIDGE ROAD
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City | WESTLAKE
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State | OH
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Zip | 44145
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Country | US
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Telephone | 440-356-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 119 BOULDER DR
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City | BEREA
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State | OH
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Zip | 44017-3120
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Country | US
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Telephone | 216-551-0297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03127210
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License Number State | OH
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