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NPI 1609498104

NPI 1609498104 : BIRD IS THE WORD LLC : ARIVACA, AZ

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General NPI Number Information
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    NPI Number           |    1609498104
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    Entity Type          |    Organization 
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    Legal Business Name  |    BIRD IS THE WORD LLC 
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Dates
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    Enumeration Date     |    05/07/2020
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    Last Update Date     |    05/07/2020
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Provider Practice Location Address
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    Address Line         |    14765 W JALISCO 
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    City                 |    ARIVACA
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    State                |    AZ
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    Zip                  |    85601
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    Country              |    US
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    Telephone            |    520-991-5233
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 99 
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    City                 |    ARIVACA
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    State                |    AZ
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    Zip                  |    85601-0099
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    Country              |    US
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    Telephone            |    520-991-5233
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     TANGYE L BECKHAM 
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    Credential           |    REGISTERED NURSE
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    Telephone            |    520-991-5233
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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       |    
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    License Number State |    
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