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General NPI Number Information
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NPI Number | 1942669304
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Entity Type | Organization
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Legal Business Name | BLUE OVAL LLC
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 02/14/2016
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Provider Practice Location Address
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Address Line | 435 NICHOLS RD SUITE 200
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City | KANSAS CITY
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State | MO
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Zip | 64112-2036
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Country | US
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Telephone | 844-521-2345
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Fax | 844-521-2345
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Provider Business Mailing Address
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Address Line | 435 NICHOLS RD SUITE 200
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City | KANSAS CITY
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State | MO
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Zip | 64112-2036
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Country | US
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Telephone | 844-521-2345
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Fax | 844-521-2345
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Authorized Official
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Title or Position | CEO
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Name | MR. PRASAD VAMAN SARAPH
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Credential |
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Telephone | 832-880-2698
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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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