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General NPI Number Information
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NPI Number | 1770963605
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Entity Type | Organization
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Legal Business Name | LASIK HOME HEALTHCARE INC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 9723 PRAIRE AVENUE
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City | HIGHLAND
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State | IN
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Zip | 46322-2606
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Country | US
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Telephone | 219-513-8201
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Fax | 219-513-9512
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Provider Business Mailing Address
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Address Line | 9723 PRAIRE AVENUE
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City | HIGHLAND
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State | IN
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Zip | 46322-2606
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Country | US
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Telephone | 219-513-8201
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Fax | 219-513-9512
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Authorized Official
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Title or Position | AGENCY ADMINISTRATOR
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Name | AMANDA PETERS
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Credential |
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Telephone | 847-418-0739
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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 | 15-013717-1
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License Number State | IN
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