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General NPI Number Information
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NPI Number | 1609053586
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Entity Type | Organization
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Legal Business Name | PRIORITY HOME CARE SERVICES
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 17 POPLAR STREET SUITE 4
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City | ROSLINDALE
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State | MA
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Zip | 02131-4302
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Country | US
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Telephone | 617-323-2276
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Fax | 617-323-2294
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Provider Business Mailing Address
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Address Line | 17 POPLAR ST SUITE 4
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City | ROSLINDALE
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State | MA
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Zip | 02131-2505
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Country | US
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Telephone | 617-323-2276
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Fax | 617-323-2494
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TEKUM FOMUM PENTOCOSTER
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Credential |
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Telephone | 617-323-2276
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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 | 7373
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License Number State | MA
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