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General NPI Number Information
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NPI Number | 1972813301
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Entity Type | Organization
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Legal Business Name | FAMILY HOME MEDICAL HOSPICE, INC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 50 S OAK ST
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City | MOUNT CARMEL
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State | PA
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Zip | 17851-2156
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Country | US
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Telephone | 570-339-4083
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Fax |
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Provider Business Mailing Address
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Address Line | 2070 W 106TH ST
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City | CARMEL
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State | IN
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Zip | 46032-7918
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Country | US
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Telephone | 317-652-1584
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DEBRA ELAINE PETRAS
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Credential |
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Telephone | 740-632-1406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | PA
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