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General NPI Number Information
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NPI Number | 1801170014
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Entity Type | Organization
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Legal Business Name | HEALTHCARE MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 7257 LEM TURNER RD SUITE 6
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City | JACKSONVILLE
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State | FL
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Zip | 32208-3371
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Country | US
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Telephone | 904-379-4750
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Fax | 904-551-2053
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Provider Business Mailing Address
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Address Line | 7257 LEM TURNER RD SUITE 6
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City | JACKSONVILLE
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State | FL
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Zip | 32208-3371
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Country | US
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Telephone | 904-379-4750
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Fax | 904-551-2053
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Authorized Official
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Title or Position | CEO
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Name | MR. DE'ARIS WILLIAM HENRY I
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Credential |
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Telephone | 609-453-7704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1000041543
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License Number State | FL
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