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General NPI Number Information
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NPI Number | 1891096822
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Entity Type | Organization
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Legal Business Name | GENESIS PRIMARY HOME CARE, LLC
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 4211 MICHAEL BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-7725
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Country | US
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Telephone | 956-289-8222
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Fax |
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Provider Business Mailing Address
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Address Line | 4211 MICHAEL BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-7725
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Country | US
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Telephone | 956-289-8222
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/PRESIDENT
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Name | MRS. DEANNETTE LEE CORTEZ
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Credential |
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Telephone | 956-289-8222
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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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