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NPI 1649268244

NPI 1649268244 : LIBBY'S HOME CARE, INC. : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1649268244
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    Entity Type          |    Organization 
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    Legal Business Name  |    LIBBY'S HOME CARE, INC. 
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Dates
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    Enumeration Date     |    10/09/2005
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    Last Update Date     |    05/08/2009
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Provider Practice Location Address
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    Address Line         |    505A OWEN DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-3433
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    Country              |    US
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    Telephone            |    910-223-9993
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    Fax                  |    910-223-9994
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Provider Business Mailing Address
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    Address Line         |    505A OWEN DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-3433
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    Country              |    US
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    Telephone            |    910-233-9993
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    Fax                  |    910-223-9994
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    MRS. DELICIA ANTONIETTE MCKOY 
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    Credential           |    RN
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    Telephone            |    910-223-9993
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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       |    HC2478
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    License Number State |    NC
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