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General NPI Number Information
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NPI Number | 1629365754
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Entity Type | Organization
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Legal Business Name | HOMECARE PROVIDERS GROUP LLC
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Dates
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Enumeration Date | 07/10/2011
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 5452 S PINEHURST AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65810-2768
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Country | US
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Telephone | 417-234-3868
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Fax | 888-511-3547
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Provider Business Mailing Address
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Address Line | 5452 S PINEHURST AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65810-2768
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Country | US
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Telephone | 417-234-3868
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Fax | 888-511-3547
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Authorized Official
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Title or Position | MANAGER
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Name | ROBERT KAIL
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Credential | NP
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Telephone | 417-234-3868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2000164718
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License Number State | MO
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