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General NPI Number Information
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NPI Number | 1710201504
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Entity Type | Organization
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Legal Business Name | COMFORTCARE DELIGHT, LLC
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 156 SW CELINE CT
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City | LAKE CITY
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State | FL
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Zip | 32024-1253
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Country | US
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Telephone | 386-755-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 156 SW CELINE CT
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City | LAKE CITY
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State | FL
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Zip | 32024-1253
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Country | US
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Telephone | 386-755-9522
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TERRIE MARIE MCCORMACK
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Credential | RN
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Telephone | 386-755-9522
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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 | RN3192592
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License Number State | FL
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