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General NPI Number Information
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NPI Number | 1790442630
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Entity Type | Organization
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Legal Business Name | MEDCURA HEALTH, INC.
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Dates
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Enumeration Date | 11/28/2021
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 3630 SHALLOWFORD RD NE
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City | DORAVILLE
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State | GA
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Zip | 30340-1019
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Country | US
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Telephone | 404-298-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 5582 MEMORIAL DR
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-3215
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Country | US
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Telephone | 404-298-8998
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF HR
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Name | BILLIE INCLAN
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Credential |
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Telephone | 404-564-9345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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