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General NPI Number Information
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NPI Number | 1801120720
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Entity Type | Organization
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Legal Business Name | LEE HEALTHCARE MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 907 NE BIG BEND TRL STE D
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City | GLEN ROSE
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State | TX
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Zip | 76043-4913
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Country | US
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Telephone | 254-897-1853
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 628
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City | HAMILTON
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State | TX
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Zip | 76531-0628
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Country | US
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Telephone | 254-386-3006
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUCY LEE
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Credential |
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Telephone | 254-386-8971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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