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NPI 1710676580

NPI 1710676580 : AGR HEALTH, LLC : CAMILLUS, NY

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General NPI Number Information
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    NPI Number           |    1710676580
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    Entity Type          |    Organization 
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    Legal Business Name  |    AGR HEALTH, LLC 
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Dates
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    Enumeration Date     |    05/05/2023
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    Last Update Date     |    05/05/2023
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Provider Practice Location Address
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    Address Line         |    327 DICKERSON DR N 
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    City                 |    CAMILLUS
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    State                |    NY
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    Zip                  |    13031-1703
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    Country              |    US
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    Telephone            |    315-396-0823
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    327 DICKERSON DR N 
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    City                 |    CAMILLUS
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    State                |    NY
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    Zip                  |    13031-1703
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    Country              |    US
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    Telephone            |    315-396-0823
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MR. ASHOKE  BOSE 
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    Credential           |    MHA
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    Telephone            |    315-396-0823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    251K00000X
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    Taxonomy Name        |    Public Health or Welfare Agency
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    License Number       |    
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    License Number State |    
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