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NPI 1750190906

NPI 1750190906 : B & H ALF OPERATIONS MUSKOGEE LLC : MUSKOGEE, OK

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General NPI Number Information
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    NPI Number           |    1750190906
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    Entity Type          |    Organization 
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    Legal Business Name  |    B & H ALF OPERATIONS MUSKOGEE LLC 
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Dates
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    Enumeration Date     |    01/02/2025
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    Last Update Date     |    01/03/2025
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Provider Practice Location Address
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    Address Line         |    3211 CHANDLER RD 
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    City                 |    MUSKOGEE
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    State                |    OK
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    Zip                  |    74403-4925
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    Country              |    US
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    Telephone            |    918-683-8388
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4900 MADISON 2035 
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    City                 |    HUNTSVILLE
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    State                |    AR
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    Zip                  |    72740-8786
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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    |    AGENT
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    Name                 |     TARA  BOX 
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    Credential           |    
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    Telephone            |    479-738-8717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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