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General NPI Number Information
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NPI Number | 1629749379
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Entity Type | Organization
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Legal Business Name | HERITAGE HEALTH PARTNERS, LLC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 2186 HAMILTON LAKE PKWY
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City | BUFORD
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State | GA
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Zip | 30519-4208
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Country | US
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Telephone | 678-895-5389
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Fax |
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Provider Business Mailing Address
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Address Line | 115 E MAIN ST # A1B-2I
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City | BUFORD
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State | GA
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Zip | 30518-5727
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Country | US
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Telephone | 470-738-7665
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCIA COLEMAN
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Credential |
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Telephone | 470-738-7665
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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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