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General NPI Number Information
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NPI Number | 1912371360
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Entity Type | Organization
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Legal Business Name | VANGUARD HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 1033 N MAYFAIR RD STE 300
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City | WAUWATOSA
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State | WI
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Zip | 53226-3442
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Country | US
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Telephone | 414-216-4516
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Fax | 414-527-1063
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Provider Business Mailing Address
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Address Line | 9310 N 107TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53224-1121
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Country | US
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Telephone | 414-216-4516
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Fax | 414-527-1063
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | ANGELIQUE GRAY
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Credential |
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Telephone | 414-216-4516
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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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