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NPI 1760013189

NPI 1760013189 : CHURCHILL SERVICES LLC : STUART, FL

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General NPI Number Information
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    NPI Number           |    1760013189
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHURCHILL SERVICES LLC 
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Dates
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    Enumeration Date     |    02/04/2020
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    Last Update Date     |    02/04/2020
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Provider Practice Location Address
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    Address Line         |    210 SW OCEAN BLVD 
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    City                 |    STUART
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    State                |    FL
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    Zip                  |    34994-2944
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    Country              |    US
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    Telephone            |    772-220-3090
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    210 SW OCEAN BLVD 
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    City                 |    STUART
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    State                |    FL
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    Zip                  |    34994-2944
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    Country              |    US
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    Telephone            |    772-220-3090
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     ANNABEL C NICOL 
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    Credential           |    
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    Telephone            |    772-220-3090
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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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