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General NPI Number Information
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NPI Number | 1861732505
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Entity Type | Individual
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Provider Name | MICHAEL M REBOL R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2013
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Last Update Date | 02/16/2013
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Provider Practice Location Address
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Address Line | 6780 MAYFIELD RD ATTN: HOSPITAL PHARMACY
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2203
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Country | US
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Telephone | 440-312-4350
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Fax |
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Provider Business Mailing Address
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Address Line | 7209 HAYES BLVD
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City | MENTOR
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State | OH
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Zip | 44060-4712
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Country | US
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Telephone | 440-951-6292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03213983
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License Number State | OH
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