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NPI 1720805807

NPI 1720805807 : TRU BLUE HOME HEALTHCARE LLC : PHOENIX, AZ

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General NPI Number Information
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    NPI Number           |    1720805807
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRU BLUE HOME HEALTHCARE LLC 
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Dates
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    Enumeration Date     |    09/20/2024
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    Last Update Date     |    09/20/2024
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Provider Practice Location Address
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    Address Line         |    16027 N 19TH DR 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85023-7280
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    Country              |    US
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    Telephone            |    480-347-9482
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    16027 N 19TH DR 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85023-7280
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    Country              |    US
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    Telephone            |    480-347-9482
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     TRU BLUE HOME HEALTH  LLC 
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    Credential           |    
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    Telephone            |    480-347-9482
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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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