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General NPI Number Information
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NPI Number | 1831557305
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Entity Type | Organization
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Legal Business Name | WILLCARE
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Dates
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Enumeration Date | 01/29/2016
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 95 N MAIN ST
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City | WELLSVILLE
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State | NY
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Zip | 14895-1280
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Country | US
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Telephone | 585-593-9410
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Fax |
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Provider Business Mailing Address
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Address Line | 95 N MAIN ST
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City | WELLSVILLE
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State | NY
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Zip | 14895-1280
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARY JO MCNINCH
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Credential |
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Telephone | 585-593-9410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 72 087951
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License Number State | NY
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