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General NPI Number Information
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NPI Number | 1770333890
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Entity Type | Organization
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Legal Business Name | PROVIDERS CHOICE HOSPICE INC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 237 W BONITA AVE STE E
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City | SAN DIMAS
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State | CA
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Zip | 91773-3048
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Country | US
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Telephone | 909-572-5777
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Fax | 909-572-8877
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Provider Business Mailing Address
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Address Line | 237 W BONITA AVE STE E
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City | SAN DIMAS
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State | CA
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Zip | 91773-3048
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Country | US
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Telephone | 909-572-5777
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Fax | 909-572-8877
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Authorized Official
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Title or Position | CEO
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Name | AARON VELASCO
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Credential |
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Telephone | 909-497-1949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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