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NPI 1821633140

NPI 1821633140 : GOLDSBY HEALTH CARE, LLC : MUNSTER, IN

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General NPI Number Information
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    NPI Number           |    1821633140
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOLDSBY HEALTH CARE, LLC 
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Dates
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    Enumeration Date     |    11/11/2019
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    Last Update Date     |    11/11/2019
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Provider Practice Location Address
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    Address Line         |    7826 CALUMET AVE STE C 
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    City                 |    MUNSTER
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    State                |    IN
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    Zip                  |    46321-1210
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    Country              |    US
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    Telephone            |    219-513-8668
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    Fax                  |    773-347-1758
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Provider Business Mailing Address
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    Address Line         |    7826 CALUMET AVE STE C 
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    City                 |    MUNSTER
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    State                |    IN
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    Zip                  |    46321-1210
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    Country              |    US
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    Telephone            |    219-513-8668
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    Fax                  |    773-347-1758
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Authorized Official
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    Title or Position    |    DIRECTOR OF NURSING
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    Name                 |     RONYA  JOHNSON 
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    Credential           |    
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    Telephone            |    219-513-8668
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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 |    
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