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General NPI Number Information
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NPI Number | 1679861629
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Entity Type | Organization
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Legal Business Name | MINIMED DISTRIBUTION CORP
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 39555 ORCHARD HILL PL STE 500 ATTN: ANGELA WARD JONES
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City | NOVI
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State | MI
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Zip | 48375-5526
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Country | US
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Telephone | 818-576-4978
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Fax |
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Provider Business Mailing Address
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Address Line | 18000 DEVONSHIRE ST ATTN: ANGELA WARD JONES
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City | NORTHRIDGE
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State | CA
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Zip | 91325-1219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR COMPLIANCE SPECIALIST
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Name | ANGELA WARD JONES
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Credential |
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Telephone | 804-550-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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