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General NPI Number Information
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NPI Number | 1801373949
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Entity Type | Organization
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Legal Business Name | ROCHESTER HOME INFUSION, INC.
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Dates
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Enumeration Date | 07/22/2018
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Last Update Date | 07/22/2018
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Provider Practice Location Address
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Address Line | 1400 ENERGY PARK DR STE 17
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City | SAINT PAUL
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State | MN
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Zip | 55108-5248
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Country | US
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Telephone | 612-315-1337
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Fax | 612-315-1309
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Provider Business Mailing Address
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Address Line | 221 1ST AVE SW STE 105
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City | ROCHESTER
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State | MN
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Zip | 55902-3107
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Country | US
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Telephone | 507-316-0001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSELYN ARCIAGA RAYMUNDO
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Credential | PHARM.D.
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Telephone | 507-316-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 265607
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License Number State | MN
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