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General NPI Number Information
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NPI Number | 1881835072
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Entity Type | Organization
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Legal Business Name | ANGEL AID LLC
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 3509 OXFORD BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63143-4208
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Country | US
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Telephone | 314-414-9000
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Fax | 314-414-9000
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Provider Business Mailing Address
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Address Line | 3509 OXFORD BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63143-4208
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Country | US
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Telephone | 314-414-9000
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Fax | 314-414-9000
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Authorized Official
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Title or Position | MANAGER/REGISTERED NURSE
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Name | MS. KATHLEEN A COPPLE
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Credential | R.N.
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Telephone | 314-374-0116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | LC0944164
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License Number State | MO
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