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General NPI Number Information
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NPI Number | 1962536219
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Entity Type | Organization
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Legal Business Name | MOUNTAIN HOME CARE EQUIPMENT, INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 INDUSTRIAL BLVD STE 113
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City | ELLIJAY
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State | GA
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Zip | 30540-3721
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Country | US
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Telephone | 706-635-4494
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Fax | 706-635-3910
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Provider Business Mailing Address
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Address Line | PO BOX 675
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City | ELLIJAY
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State | GA
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Zip | 30540-0009
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Country | US
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Telephone | 706-635-4494
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Fax | 706-635-3910
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. PAM RHODES
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Credential |
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Telephone | 706-635-4494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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