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General NPI Number Information
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NPI Number | 1770622540
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Entity Type | Organization
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Legal Business Name | MARK E MCCARTHY PC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 4990 E MEDITERRANEAN DR SUITE D
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2494
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Country | US
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Telephone | 520-417-1163
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Fax | 520-417-1165
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Provider Business Mailing Address
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Address Line | PO BOX 1177
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City | HEREFORD
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State | AZ
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Zip | 85615-1177
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Country | US
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Telephone | 520-417-1163
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Fax | 520-417-1165
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Authorized Official
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Title or Position | MANAGER
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Name | MS. CAROLYN HARE
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Credential | R.N.
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Telephone | 520-417-1163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 24241
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License Number State | AZ
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