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General NPI Number Information
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NPI Number | 1598505521
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Entity Type | Organization
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Legal Business Name | DRAGONFLY HOSPICE PHARMACY, LLC
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 2404 NE CONNERS AVE STE 100
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City | BEND
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State | OR
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Zip | 97701-6371
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Country | US
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Telephone | 541-948-8809
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Fax | 888-390-1545
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Provider Business Mailing Address
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Address Line | 264 SMITH TOWNSHIP STATE RD STE 5
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City | BURGETTSTOWN
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State | PA
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Zip | 15021-2124
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Country | US
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Telephone | 724-414-1425
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Fax |
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Authorized Official
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Title or Position | VP PHARMACY SERVICES
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Name | DR. MICHELLE MIKUS
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Credential | PHARMD
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Telephone | 412-403-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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