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General NPI Number Information
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NPI Number | 1801205075
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 3 WATERS PARK DR SUITE 225
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City | SAN MATEO
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State | CA
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Zip | 94403-1160
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Country | US
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Telephone | 650-242-4332
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Fax | 855-339-0135
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Provider Business Mailing Address
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Address Line | 790 E COLORADO BLVD SUITE 850
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City | PASADENA
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State | CA
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Zip | 91101-2113
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Country | US
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Telephone | 626-204-7930
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Fax | 626-204-7950
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH MALLINGER
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Credential |
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Telephone | 626-204-7930
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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 |
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License Number State | CA
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