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Showing codes 1912098294 — 1639260920
1912098294 -
HUNG NGUYEN, M.D., INC.
Other Name
:
Mailing Address
:
210 N TUSTIN AVE
SANTA ANA
CA
92705-3807
Phone
: 800-883-7243;
Fax
: 714-647-1245;
Practice Location Address
:
9920 TALBERT AVE
,
, FOUNTAIN VALLEY
, CA
, 92708-5153
Practice Phone
: 800-883-7243;
Practice Fax
:
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1821189101 -
BHASKER MEDICAL CLINIC PC
Other Name
:
Mailing Address
:
200 NEEL AVE
SOCORRO
NM
87801-4649
Phone
: 575-835-2940;
Fax
: 575-835-2216;
Practice Location Address
:
200 NEEL AVE
,
, SOCORRO
, NM
, 87801-4649
Practice Phone
: 575-835-2940;
Practice Fax
: 575-835-2216
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1730270018 -
DR.
DR.
KEITH
WAYNE
RUSSELL
D O
Other Name
:
Mailing Address
:
1200 NE 13TH ST
OKLAHOMA CITY
OK
73152-3277
Phone
: 405-522-2368;
Fax
: 405-522-4120;
Practice Location Address
:
1200 NE 13TH ST
,
, OKLAHOMA CITY
, OK
, 73152-3277
Practice Phone
: 405-522-2368;
Practice Fax
: 405-522-4120
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1649361924 -
MRS.
MRS.
JOANNE
M
DIELMANN
R.D., L.D., C.D.E.
Other Name
:
Mailing Address
:
PO BOX 631568
BALTIMORE
MD
21263-1568
Phone
: ;
Fax
: ;
Practice Location Address
:
6565 N CHARLES ST
, STE 507
, BALTIMORE
, MD
, 21204-6800
Practice Phone
: 443-849-2036;
Practice Fax
:
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1558452839 -
DR.
DR.
JOHN
LEDONNE
M.D.
Other Name
:
Mailing Address
:
PO BOX 631568
BALTIMORE
MD
21263-1568
Phone
: ;
Fax
: ;
Practice Location Address
:
6701 N CHARLES ST
, DEPT OF SURGERY
, BALTIMORE
, MD
, 21204-6808
Practice Phone
: 443-849-2000;
Practice Fax
:
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1467543744 -
DR.
DR.
NIKUNJ
J
PUROHIT
M.D.
Other Name
:
Mailing Address
:
9114 PHILADELPHIA RD
SUITE 108
BALTIMORE
MD
21237-4345
Phone
: 410-918-0777;
Fax
: 410-369-1707;
Practice Location Address
:
9114 PHILADELPHIA RD
, SUITE 108
, BALTIMORE
, MD
, 21237-4345
Practice Phone
: 410-918-0777;
Practice Fax
: 410-369-1707
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1376634659 -
MRS.
MRS.
AMANDA
L
WILSON
MBA, CADC
Other Name
:
Mailing Address
:
1196 PALMETTO ROAD
TUPELO
MS
38804
Phone
: 662-566-2551;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 920 BOONE STREET
, TUPELO
, MS
, 38804
Practice Phone
: 662-844-3531;
Practice Fax
: 662-844-1757
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1285725564 -
DIANE
T
NELSON
R.PH.
Other Name
:
Mailing Address
:
3601 S 6TH AVENUE
TUCSON
AZ
85723
Phone
: 520-792-1450;
Fax
: ;
Practice Location Address
:
3601 S 6TH AVENUE
,
, TUCSON
, AZ
, 85723
Practice Phone
: 520-792-1450;
Practice Fax
:
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1093806374 -
DIGESTIVE HEALTHCARE ASSOCIATES PC
Other Name
:
Mailing Address
:
8865 W 400 N #155
MICHIGAN CITY
IN
46360
Phone
: 219-362-4887;
Fax
: 219-872-2712;
Practice Location Address
:
8865 W 400 N #155
,
, MCIHGAN CITY
, IN
, 46360
Practice Phone
: 219-362-4887;
Practice Fax
: 219-872-2712
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1902997281 -
MRS.
MRS.
AMELIA
T
LADREYT
MACE, LCMHT
Other Name
:
Mailing Address
:
502 EXCHANGE STREET
TUPELO
MS
38801
Phone
: 662-372-4582;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH-CHEMICAL DEPENCY SERVICES
, 920 BOONE STREET
, TUPELO
, MS
, 38804
Practice Phone
: 662-844-3531;
Practice Fax
: 662-844-1757
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1811088198 -
SAM'S CLUB OPTICAL
Other Name
:
Mailing Address
:
702 SW 8TH STREET
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
1700 WESEL BLVD
,
, HAGERSTOWN
, MD
, 21740-5389
Practice Phone
: 301-714-0096;
Practice Fax
:
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1548351828 -
MS.
MS.
MARCY
K.
DEEMEDIO
APN
Other Name
:
Mailing Address
:
500 STOCKLEY ST OFC
REHOBOTH BEACH
DE
19971-1846
Phone
: 302-227-3172;
Fax
: 302-227-5176;
Practice Location Address
:
500 STOCKLEY ST OFC
,
, REHOBOTH BEACH
, DE
, 19971-1846
Practice Phone
: 302-227-3172;
Practice Fax
: 302-227-5176
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1457442733 -
DR.
DR.
MARIA CARMEN
G.
DIAZ
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-1400;
Fax
: 302-651-4945;
Practice Location Address
:
1600 ROCKLAND ROAD
, NEMOURS/DUPONT HOSPITAL FOR CHILDREN
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1366533648 -
HOLLY
GALLOWAY
B.S.
Other Name
:
Mailing Address
:
10710 OLD HIGHWAY 64
BOLIVAR
TN
38008-3587
Phone
: 731-658-6113;
Fax
: 731-658-6165;
Practice Location Address
:
10710 OLD HIGHWAY 64
,
, BOLIVAR
, TN
, 38008-3587
Practice Phone
: 731-658-6113;
Practice Fax
: 731-658-6165
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1275624553 -
MR.
MR.
SPYRIDON
J.
CONDOS
DDS
Other Name
:
Mailing Address
:
115 CENTRAL PARK W
NEW YORK
NY
10023
Phone
: 212-799-6900;
Fax
: 212-769-2290;
Practice Location Address
:
115 CENTRAL PARK W
,
, NEW YORK
, NY
, 10023
Practice Phone
: 212-799-6900;
Practice Fax
: 212-769-2290
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1184715468 -
JOANNA
GORMAN
Other Name
:
Mailing Address
:
3109 LOTUS HILL DR
LAS VEGAS
NV
89134-8988
Phone
: 702-247-1908;
Fax
: ;
Practice Location Address
:
1800 W CHARLESTON BLVD
,
, LAS VEGAS
, NV
, 89102-2329
Practice Phone
: 702-207-8205;
Practice Fax
:
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1992896278 -
JANET
L
CARLSON
RN
Other Name
:
Mailing Address
:
199 HOME RD
JUNEAU
WI
53039-1401
Phone
: 920-386-3500;
Fax
: 920-386-3812;
Practice Location Address
:
199 HOME RD
,
, JUNEAU
, WI
, 53039-1401
Practice Phone
: 920-386-3500;
Practice Fax
: 920-386-3812
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1801987185 -
ANIL
KUMAR
GANDHI
MD
Other Name
:
Mailing Address
:
71 WEST 156TH STREET
SUITE 206
HARVEY
IL
60426-4262
Phone
: 708-339-8833;
Fax
: 708-333-4229;
Practice Location Address
:
71 WEST 156TH STREET
, SUITE 206
, HARVEY
, IL
, 60426-4262
Practice Phone
: 708-339-8833;
Practice Fax
: 708-333-4229
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1710078092 -
KAREN
LEWIS
Other Name
:
Mailing Address
:
701 18TH AVE NW STE 200
AUSTIN
MN
55912-1850
Phone
: ;
Fax
: ;
Practice Location Address
:
701 18TH AVE NW STE 200
,
, AUSTIN
, MN
, 55912-1850
Practice Phone
: 763-689-5385;
Practice Fax
:
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1629169909 -
DR.
DR.
MICHAEL
THOMAS
FLYNN
D.D.S.
Other Name
:
Mailing Address
:
27249 RUSLYNN DR
WINONA
MN
55987-4971
Phone
: 507-452-9035;
Fax
: 507-457-3269;
Practice Location Address
:
560 DEBRA DR
,
, LEWISTON
, MN
, 55952-2104
Practice Phone
: 507-523-2267;
Practice Fax
: 507-523-2206
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1538250816 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1083705362 -
IRWIN
ENDELMAN
MD
Other Name
:
Mailing Address
:
PO BOX 1969
COPPELL
TX
75019-1903
Phone
: 972-981-7927;
Fax
: 972-981-7928;
Practice Location Address
:
6130 W. PARKER RD
, MOB 1 STE 310
, PLANO
, TX
, 75093
Practice Phone
: 972-981-7927;
Practice Fax
: 972-981-7928
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1891886172 -
CURTIS
WIGGINS
Other Name
:
Mailing Address
:
PO BOX 1589
BENTON
AR
72018-1589
Phone
: 501-315-3344;
Fax
: ;
Practice Location Address
:
1628 E PAGE AVE
,
, MALVERN
, AR
, 72104
Practice Phone
: 501-315-3344;
Practice Fax
:
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1700977089 -
MS.
MS.
CHARMEN
LEIGH
SHOEMAKER
LMSW
Other Name
:
Mailing Address
:
941 HWY 9 NORTH
BRUCE
MS
38915
Phone
: ;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1619068996 -
MR.
MR.
DANNY
B
MCBRAYER
MED
Other Name
:
Mailing Address
:
1295 WINWOOD COVE
TUPELO
MS
38801
Phone
: 662-871-3432;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH-CHEMICAL DEPENDENCY SERVICES
, 920 BOONE STREET
, TUPELO
, MS
, 38804
Practice Phone
: 662-844-3531;
Practice Fax
: 662-844-1757
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1528159803 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
5315 CORTEZ RD W
,
, BRADENTON
, FL
, 34210-2814
Practice Phone
: 941-798-9341;
Practice Fax
:
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1437240710 -
SAM'S CLUB OPTICAL
Other Name
:
Mailing Address
:
702 SW 8TH STREET
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
5300 30TH ST E
,
, BRADENTON
, FL
, 34203-8400
Practice Phone
: 941-739-2130;
Practice Fax
:
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1346331626 -
DR.
DR.
MICHAEL
A.
ALEXANDER
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1255422531 -
DR.
DR.
MICHAEL
B.
BOBER
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1164513446 -
MS.
MS.
MARILYN
L.
BOOS
APN
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4946;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1073604351 -
MS.
MS.
MELINDA
S.
BROWN
CRNA
Other Name
:
Mailing Address
:
P.O. BOX 191
ROCKLAND
DE
19723-0191
Phone
: 302-651-4000;
Fax
: 302-651-4945;
Practice Location Address
:
1600 ROCKLAND RD
, NEMOURS DUPONT PEDIATRICS
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4200;
Practice Fax
: 302-651-5365
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1982795266 -
DR.
DR.
MARY
R.
FESTA
D.O.
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1891886180 -
DR.
DR.
NANCY
CAPPIELLO
DC
Other Name
:
Mailing Address
:
562 SARATOGA RD
SCOTIA
NY
12302-5731
Phone
: 518-399-2252;
Fax
: 518-399-4712;
Practice Location Address
:
562 SARATOGA RD
,
, SCOTIA
, NY
, 12302-5731
Practice Phone
: 518-399-2252;
Practice Fax
: 518-399-4712
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1700977097 -
MR.
MR.
CARL
SIMMERER
II
M.A.
Other Name
:
Mailing Address
:
2035 E BALL RD STE 200
ANAHEIM
CA
92806-5157
Phone
: ;
Fax
: ;
Practice Location Address
:
2035 E BALL RD STE 200
,
, ANAHEIM
, CA
, 92806-5157
Practice Phone
: 714-517-6300;
Practice Fax
:
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1619068905 -
LYNN
E
MCBRIDE
LPC, LMFT,CSAC
Other Name
:
Mailing Address
:
134 ELON RD
MADISON HEIGHTS
VA
24572-2536
Phone
: 434-455-2480;
Fax
: 434-455-2487;
Practice Location Address
:
320 FEDERAL ST
,
, LYNCHBURG
, VA
, 24504-2306
Practice Phone
: 434-947-5967;
Practice Fax
: 434-947-5971
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1528159811 -
MS.
MS.
KIM
J
SCOTT
Other Name
:
Mailing Address
:
40 MONMOUTH RD
OAKHURST
NJ
07755-1654
Phone
: 732-263-1220;
Fax
: 732-222-3019;
Practice Location Address
:
40 MONMOUTH RD
,
, OAKHURST
, NJ
, 07755-1654
Practice Phone
: 732-263-1220;
Practice Fax
: 732-222-3019
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1982795274 -
MRS.
MRS.
DEBBIE
LYNN
BANKO
CMHT, MS
Other Name
:
Mailing Address
:
708 DANIELLE COVE
TUPELO
MS
38801
Phone
: 662-844-4081;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1790876084 -
PAMELA
ELAINE
ALBO
PAC
Other Name
:
Mailing Address
:
3157 N RAINBOW BLVD # 518
LAS VEGAS
NV
89108-4578
Phone
: 702-912-4100;
Fax
: 702-386-4701;
Practice Location Address
:
7220 S CIMARRON RD STE 270
,
, LAS VEGAS
, NV
, 89113-2160
Practice Phone
: 702-912-4100;
Practice Fax
: 702-386-4701
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1609967991 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
2001 US HIGHWAY 1
,
, SEBASTIAN
, FL
, 32958-1615
Practice Phone
: 772-589-8528;
Practice Fax
:
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1518058809 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
3535 APALACHEE PKWY
,
, TALLAHASSEE
, FL
, 32311-5330
Practice Phone
: 850-656-2732;
Practice Fax
:
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1427149715 -
DR.
DR.
PAUL
C.
ANISMAN
MD
Other Name
:
Mailing Address
:
P.O. BOX 191
ROCKLAND
DE
19723-0191
Phone
: 302-651-4000;
Fax
: 302-651-4945;
Practice Location Address
:
1600 ROCKLAND ROAD
,
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4200;
Practice Fax
: 302-651-5345
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1336230622 -
MS.
MS.
MICHELLE
L.
BARON
APN
Other Name
:
Mailing Address
:
NEMOURS CHILDRENS CLINIC
P.O. BOX 404112
ATLANTA
GA
30384-0001
Phone
: 904-390-3610;
Fax
: 904-288-5890;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1245321538 -
MS.
MS.
MILDRED
D.
BOETTCHER
APN
Other Name
:
Mailing Address
:
34TH AND CIVIC CENTER BLVD
PHILADELPHIA
PA
19104
Phone
: 215-590-3630;
Fax
: 215-590-3606;
Practice Location Address
:
34TH AND CIVIC CENTER BLVD
,
, PHILADELPHIA
, PA
, 19104
Practice Phone
: 215-590-3630;
Practice Fax
: 215-590-3606
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1154412443 -
DR.
DR.
OMAR
DABBAGH
MD
Other Name
:
Mailing Address
:
NEMOURS CHILDRENS CLINIC
P.O. BOX 404112
ATLANTA
GA
30384-0001
Phone
: 904-390-3610;
Fax
: 904-288-5890;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1063503357 -
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1972694263 -
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: ;
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: ;
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:
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1881785178 -
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: ;
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1699866988 -
REHAB 1OF CHARLOTTE COUNTY, INC.
Other Name
:
Mailing Address
:
4166 TAMIAMI TRL
SUITE A
PORT CHARLOTTE
FL
33952-9209
Phone
: 941-766-1110;
Fax
: 941-766-1190;
Practice Location Address
:
4166 TAMIAMI TRL
, SUITE A
, PORT CHARLOTTE
, FL
, 33952-9209
Practice Phone
: 941-766-1110;
Practice Fax
: 941-766-1190
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1508957895 -
ANGELA
NOVELA
BUFFENN
MD
Other Name
:
Mailing Address
:
6430 W SUNSET BLVD
SUITE 600
LOS ANGELES
CA
90028-7901
Phone
: 323-361-2337;
Fax
: 323-361-8491;
Practice Location Address
:
4650 W SUNSET BLVD
, MS# 88
, LOS ANGELES
, CA
, 90027-6062
Practice Phone
: 323-361-2344;
Practice Fax
: 323-361-6283
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1417048703 -
DR.
DR.
GWENDOLYN
SNYDER
M.D.
Other Name
:
Mailing Address
:
601 ELMWOOD AVE
BOX 655
ROCHESTER
NY
14642-0001
Phone
: 585-341-6880;
Fax
: ;
Practice Location Address
:
1000 SOUTH AVE
,
, ROCHESTER
, NY
, 14642-0001
Practice Phone
: 585-341-6880;
Practice Fax
:
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1407947799 -
WAL-MART STORES EAST, LP
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:
Mailing Address
:
702 SW 8TH ST
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
1400 HUDSON BRIDGE RD
,
, STOCKBRIDGE
, GA
, 30281
Practice Phone
: 770-474-0121;
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:
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1316038607 -
ROGER
T
JOHNSON
PAC
Other Name
:
Mailing Address
:
PO BOX 1650
FAMILY HEALTHCARE ASSOC INC
PINEVILLE
WV
24874
Phone
: 304-732-6735;
Fax
: 304-732-9161;
Practice Location Address
:
MAIN ST
, FAMILY HEALTHCARE ASSOC INC
, PINEVILLE
, WV
, 24874
Practice Phone
: 304-732-6735;
Practice Fax
: 304-732-9161
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1225129513 -
DR.
DR.
CARRIE
KAME
MCDOUGAL
DDS
Other Name
:
Mailing Address
:
1206 GULL RD
KALAMAZOO
MI
49048-1736
Phone
: 269-385-2100;
Fax
: 269-385-2538;
Practice Location Address
:
1206 GULL RD
,
, KALAMAZOO
, MI
, 49048-1736
Practice Phone
: 269-385-2100;
Practice Fax
: 269-385-2538
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1134210420 -
MRS.
MRS.
SHANNON
J.
ANTUNES
APN
Other Name
:
Mailing Address
:
NEMOURS CHILDRENS CLINIC
P.O. BOX 404112
ATLANTA
GA
30384-0001
Phone
: 904-390-3610;
Fax
: 904-288-5890;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1043301336 -
MS.
MS.
SHERRIE
S
BRADY
PA-C
Other Name
:
Mailing Address
:
CORPORATE CREDENTIALING
P.O. BOX 269
WILMINGTON
DE
19899
Phone
: 302-651-5938;
Fax
: 302-651-6077;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-5345
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1952492241 -
MR.
MR.
ROBERT
P.
BRISLIN
DO
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT
ROCKLAND
DE
19732-0191
Phone
: ;
Fax
: 302-651-4945;
Practice Location Address
:
1600 ROCKLAND RD
,
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4200;
Practice Fax
: 302-651-4945
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1861583155 -
MS.
MS.
STEPHANIE
W.
CARVER
APN
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1770674061 -
DR.
DR.
SABINA
S.
DICINDIO
D.O.
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1689765976 -
DR.
DR.
STEPHEN
C.
EPPES
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1497846786 -
JANET
MARIE
HARGADON
MASTERS OF ARTS
Other Name
:
Mailing Address
:
143 ROCKRIDGE RD
SAN CARLOS
CA
94070-3703
Phone
: 650-592-9222;
Fax
: 650-592-5009;
Practice Location Address
:
3801 MIRANDA AVE # 126
,
, PALO ALTO
, CA
, 94304-1207
Practice Phone
: 650-493-5000;
Practice Fax
: 650-849-0516
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1306937693 -
SUZANNE M. DAVIS, RPT. INC
Other Name
:
Mailing Address
:
447 NW 73RD AVE
PLANTATION
FL
33317-1608
Phone
: 954-583-7383;
Fax
: 954-583-7388;
Practice Location Address
:
447 NW 73RD AVE
,
, PLANTATION
, FL
, 33317-1608
Practice Phone
: 954-583-7383;
Practice Fax
: 954-583-7388
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1215028501 -
LUBBOCK DIAGNOSTIC RADIOLOGY, L.L.P.
Other Name
:
Mailing Address
:
PO BOX 1620
LUBBOCK
TX
79408-1620
Phone
: 806-792-2767;
Fax
: 806-791-6709;
Practice Location Address
:
4005 24TH ST
,
, LUBBOCK
, TX
, 79410-1835
Practice Phone
: 806-792-2767;
Practice Fax
: 888-861-8858
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1124119417 -
MR.
MR.
ROBERT
LEE
CLAYBORN
SR.
CO
Other Name
:
Mailing Address
:
214 ROCK CREEK CT
YORKTOWN
VA
23693-5542
Phone
: 662-292-3887;
Fax
: ;
Practice Location Address
:
100 EMANCIPATION DR
,
, HAMPTON
, VA
, 23667
Practice Phone
: 757-722-9961;
Practice Fax
: 757-728-3173
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1033200324 -
DR.
DR.
DON
T
HARADA
DC
Other Name
:
Mailing Address
:
1580 MAKALOA STREET
SUITE 798
HONOLULU
HI
96814-3283
Phone
: 808-947-7575;
Fax
: 808-941-4026;
Practice Location Address
:
1580 MAKALOA STREET
, SUITE 798
, HONOLULU
, HI
, 96814-3283
Practice Phone
: 808-947-7575;
Practice Fax
: 808-941-4026
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1942391230 -
THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH AN AFFILIATE OF UABHS
Other Name
:
Mailing Address
:
PO BOX 241145
MONTGOMERY
AL
36124-1145
Phone
: 334-747-4307;
Fax
: 334-747-4172;
Practice Location Address
:
124 S MEMORIAL DR
,
, PRATTVILLE
, AL
, 36067-3619
Practice Phone
: 334-361-4267;
Practice Fax
: 334-361-3131
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1851482145 -
TRACY
BAUCOM
KENT
LPA
Other Name
:
Mailing Address
:
3907 WRIGHTSVILLE AVE
SUITE 110
WILMINGTON
NC
28403-6246
Phone
: 910-799-6162;
Fax
: 910-799-6171;
Practice Location Address
:
3907 WRIGHTSVILLE AVE.
, SUITE 110
, WILMINGTON
, NC
, 28401-6626
Practice Phone
: 910-799-6162;
Practice Fax
: 910-799-6171
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1760573059 -
COMFORT CARE HOSPICE, LLC
Other Name
:
Mailing Address
:
3535 NW 58TH
SUITE 765
OKLAHOMA CITY
OK
73112
Phone
: 405-602-0440;
Fax
: 405-602-0442;
Practice Location Address
:
3535 NW 58TH
, SUITE 765
, OKLAHOMA CITY
, OK
, 73112
Practice Phone
: 405-602-0440;
Practice Fax
: 405-602-0442
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1679664965 -
MRS.
MRS.
DEBRA
KAYE
SMITH
MS
Other Name
:
Mailing Address
:
105 PRAIRIE STREET
OKOLONA
MS
38860
Phone
: 662-447-3520;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1588755870 -
ABBIS MEDICAL SUPPLY, INC
Other Name
:
Mailing Address
:
12999 MURPHY RD
SUITTE N8
STAFFORD
TX
77477
Phone
: 832-244-0501;
Fax
: ;
Practice Location Address
:
12999 MURPHY RD
, SUITE N8
, STAFFORD
, TX
, 77477
Practice Phone
: 832-244-0501;
Practice Fax
:
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1396836680 -
DR.
DR.
JULIE
D
BRACK
M.D.
Other Name
:
Mailing Address
:
8800 PENROSE LN APT 242
LENEXA
KS
66219-8156
Phone
: 913-219-1095;
Fax
: ;
Practice Location Address
:
23351 PRAIRIE STAR PKWY STE A245
,
, LENEXA
, KS
, 66227-7301
Practice Phone
: 913-676-8630;
Practice Fax
: 913-676-8635
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1205927597 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
6830 NORMANDY BLVD
,
, JACKSONVILLE
, FL
, 32205-6210
Practice Phone
: 904-786-0390;
Practice Fax
:
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1750472049 -
TERRANCE
JOSEPH
DRAKE
M.D.
Other Name
:
Mailing Address
:
8003 CASTLEWAY DR
INDIANAPOLIS
IN
46250-1946
Phone
: 317-576-1335;
Fax
: 317-576-1339;
Practice Location Address
:
8003 CASTLEWAY DR
,
, INDIANAPOLIS
, IN
, 46250-1946
Practice Phone
: 317-576-1335;
Practice Fax
: 317-576-1339
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1669563953 -
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:
Mailing Address
:
Phone
: ;
Fax
: ;
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:
,
,
,
,
Practice Phone
: ;
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:
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1578654869 -
MS.
MS.
ROBIN
B
BUCKINGHAM
PA-C
Other Name
:
Mailing Address
:
280 CHESTNUT ST
2ND FL
SPRINGFIELD
MA
01199-1619
Phone
: 413-794-5700;
Fax
: ;
Practice Location Address
:
3400 MAIN ST
,
, SPRINGFIELD
, MA
, 01107-1113
Practice Phone
: 413-794-9560;
Practice Fax
: 413-794-5884
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1487745774 -
DR.
DR.
RUSEL
PAUL
HOLLISTER
D.D.S, M.S.
Other Name
:
Mailing Address
:
4426 W KL AVE
KALAMAZOO
MI
49006-5723
Phone
: 269-353-7700;
Fax
: 269-353-7788;
Practice Location Address
:
4426 W KL AVE
,
, KALAMAZOO
, MI
, 49006-5723
Practice Phone
: 269-353-7700;
Practice Fax
: 269-353-7788
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1295826584 -
STAND-UP MRI OF CARLE PLACE, P.C.
Other Name
:
Mailing Address
:
PO BOX 170
FARMINGDALE
NY
11735-0170
Phone
: 631-694-2816;
Fax
: 631-396-1056;
Practice Location Address
:
31 OLD COUNTRY RD
,
, CARLE PLACE
, NY
, 11514-1800
Practice Phone
: 516-746-2248;
Practice Fax
: 516-746-2218
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1104917491 -
JEANNETTE
A
BLAHA
CRNA
Other Name
:
Mailing Address
:
333 ROUTE 25A STE 225
ROCKY POINT
NY
11778-8802
Phone
: 631-744-3671;
Fax
: ;
Practice Location Address
:
333 ROUTE 25A STE 225
,
, ROCKY POINT
, NY
, 11778-8802
Practice Phone
: 631-744-3671;
Practice Fax
:
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1013008309 -
PENINSULA NEUROLOGY LTD
Other Name
:
Mailing Address
:
802 LOCKWOOD AVE STE A
NEWPORT NEWS
VA
23602-4479
Phone
: 757-872-9797;
Fax
: 757-872-9711;
Practice Location Address
:
802 LOCKWOOD AVE STE A
,
, NEWPORT NEWS
, VA
, 23602-4479
Practice Phone
: 757-872-9797;
Practice Fax
: 757-872-9711
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1922199215 -
MS.
MS.
CARON
YVONNE
ROWE
K.T.
Other Name
:
Mailing Address
:
2111 HOLLY HALL ST
202
HOUSTON
TX
77054-3970
Phone
: 713-790-0516;
Fax
: 713-794-7631;
Practice Location Address
:
2002 HOLCOMBE BLVD
, 117/RCL
, HOUSTON
, TX
, 77030-4211
Practice Phone
: 713-794-7054;
Practice Fax
: 713-794-7631
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1831280122 -
DR.
DR.
MICHAEL
DEAN
MITCHAEL
D.C.
Other Name
:
Mailing Address
:
6109 E 13TH ST N
WICHITA
KS
67208-2653
Phone
: 316-681-2219;
Fax
: ;
Practice Location Address
:
6109 E 13TH ST N
,
, WICHITA
, KS
, 67208-2653
Practice Phone
: 316-681-2219;
Practice Fax
:
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1740371038 -
DR.
DR.
NATALIE
LEONID
LENDER
M.D.
Other Name
:
Mailing Address
:
124 WATERTOWN ST
SUITE 2 D
WATERTOWN
MA
02472-2576
Phone
: 617-916-5069;
Fax
: 617-467-4073;
Practice Location Address
:
124 WATERTOWN ST
, SUITE 2 D
, WATERTOWN
, MA
, 02472-2576
Practice Phone
: 617-916-5069;
Practice Fax
: 617-467-4073
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1659462943 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1568553857 -
DR.
DR.
THOMAS
MICHAEL
DAVIDSON
D.D.S.
Other Name
:
Mailing Address
:
58047 VAN DYKE RD
SUITE# 101
WASHINGTON
MI
48094-4000
Phone
: 586-270-6013;
Fax
: 586-207-6300;
Practice Location Address
:
58047 VAN DYKE RD
, SUITE# 101
, WASHINGTON
, MI
, 48094-4000
Practice Phone
: 586-270-6013;
Practice Fax
: 586-207-6300
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1477644763 -
MARGARET
ANN
MUELLER BRANDENBURG
OTR/L
Other Name
:
Mailing Address
:
5805 UPTON AVE S
MINNEAPOLIS
MN
55410-2960
Phone
: ;
Fax
: ;
Practice Location Address
:
2450 RIVERSIDE AVE
,
, MINNEAPOLIS
, MN
, 55454-1450
Practice Phone
: 612-672-6000;
Practice Fax
:
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1386735678 -
SHERRI
L
YOUNG
OTR.L
Other Name
:
Mailing Address
:
3577 CROSSTREES LN
MOUNT PLEASANT
SC
29466-7500
Phone
: 828-693-8972;
Fax
: ;
Practice Location Address
:
4105 FABER PLACE DR STE 490
,
, NORTH CHARLESTON
, SC
, 29405-8594
Practice Phone
: 843-894-7374;
Practice Fax
:
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1194816488 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1003907395 -
MRS.
MRS.
DOROTHY
ELDER
FORD
Other Name
:
Mailing Address
:
PO BOX 2818
TUPELO
MS
38801
Phone
: 662-844-5893;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1912098203 -
MRS.
MRS.
RITA
DIANE
WEATHERFORD
BA
Other Name
:
Mailing Address
:
167 CR 83
TUPELO
MS
38801
Phone
: ;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1821189119 -
MRS.
MRS.
DONNA
RAQUEL
ROSAMOND
LPC
Other Name
:
Mailing Address
:
2139 FAULKNER ROAD
BELDEN
MS
38826
Phone
: 662-509-6771;
Fax
: ;
Practice Location Address
:
REGION III MENTAL HEALTH CENTER
, 2434 SOUTH EASON BLVD
, TUPELO
, MS
, 38804-6942
Practice Phone
: 662-844-1717;
Practice Fax
: 662-680-6416
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1730270026 -
JONATHAN
L
KARPER
PAC
Other Name
:
Mailing Address
:
PO BOX 1650
FAMILY HEALTHCARE ASSOC INC
PINEVILLE
WV
24874
Phone
: 304-732-6735;
Fax
: 304-732-9218;
Practice Location Address
:
MAIN ST
, FAMILY HEALTHCARE ASSOC INC
, PINEVILLE
, WV
, 24874
Practice Phone
: 304-732-6735;
Practice Fax
: 304-732-9218
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1649361932 -
DR.
DR.
TANIA
D.
BURNS
MD
Other Name
:
Mailing Address
:
NEMOURS CHILDRENS CLINIC
P.O. BOX 404112
ATLANTA
GA
30384-0001
Phone
: 904-390-3610;
Fax
: 904-288-5890;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1558452847 -
MS.
MS.
THERESA
A.
DITUNNO-LEE
CRNA
Other Name
:
THERESA
DITUNNO
Mailing Address
:
P.O. BOX 191
ROCKLAND
DE
19723-0191
Phone
: 302-651-4000;
Fax
: 302-651-4945;
Practice Location Address
:
1600 ROCKLAND ROAD
,
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4200;
Practice Fax
: 302-651-5365
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1467543751 -
DR.
DR.
YAMINI
DURANI
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
A.I. DUPONT HOSPITAL FOR CHILDREN
, 1600 ROCKLAND ROAD
, WILMINGTON
, DE
, 19803-3607
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1376634667 -
KENNETH
R
CLOWERS
P.T.
Other Name
:
Mailing Address
:
9600 BUCKHAVEN CT
KNOXVILLE
TN
37923-2071
Phone
: 865-809-4927;
Fax
: ;
Practice Location Address
:
100 LETORY RD
,
, WARTBURG
, TN
, 37887-3224
Practice Phone
: 423-346-3220;
Practice Fax
: 423-346-3223
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1285725572 -
ROBYNN
CHRISTINE
WILHELMI
PT
Other Name
:
ROBYNN
CHRISTINE
POPPE
Mailing Address
:
403 LEINBACH CT
CARY
NC
27513-5759
Phone
: 919-414-8057;
Fax
: ;
Practice Location Address
:
2709 BLUE RIDGE RD
,
, RALEIGH
, NC
, 27607-6462
Practice Phone
: 919-784-4676;
Practice Fax
:
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1093806382 -
DR.
DR.
SHELLEE
RAE
LAZAR
M.D.
Other Name
:
SHELLEE
RAE
MIYASATO
Mailing Address
:
PO BOX 9595
REDLANDS
CA
92375-2795
Phone
: 909-335-5616;
Fax
: 909-307-7518;
Practice Location Address
:
350 TERRACINA BLVD
,
, REDLANDS
, CA
, 92373-4850
Practice Phone
: 909-335-5616;
Practice Fax
: 909-307-7518
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1902997299 -
SALMON FALLS PATHOLOGY LLC
Other Name
:
Mailing Address
:
PO BOX 1849
LEWISTON
ME
04241-1849
Phone
: 207-784-2554;
Fax
: 207-777-5363;
Practice Location Address
:
15 WHITEHALL RD
,
, ROCHESTER
, NH
, 03867
Practice Phone
: 603-335-8195;
Practice Fax
: 603-330-0098
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1811088107 -
SANA ABUMERI M D INC
Other Name
:
Mailing Address
:
860 E BROAD ST
ELYRIA
OH
44035-6542
Phone
: 440-284-3800;
Fax
: 440-284-3813;
Practice Location Address
:
860 E BROAD ST
,
, ELYRIA
, OH
, 44035-6542
Practice Phone
: 440-284-3800;
Practice Fax
: 440-284-3813
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1720179013 -
MR.
MR.
DONALD
O'DELL
MATTHEWS
L.P.C.
Other Name
:
Mailing Address
:
199 HOME RD
JUNEAU
WI
53039-1401
Phone
: 920-386-3500;
Fax
: 920-386-3812;
Practice Location Address
:
199 HOME RD
,
, JUNEAU
, WI
, 53039-1401
Practice Phone
: 920-386-3500;
Practice Fax
: 920-386-3812
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1639260920 -
DR.
DR.
ALBERT
H
BRADEN
III
M.D.
Other Name
:
Mailing Address
:
3400 BISSONNET ST STE 100
HOUSTON
TX
77005-2153
Phone
: 713-662-2777;
Fax
: 713-665-6227;
Practice Location Address
:
3400 BISSONNET ST STE 100
,
, HOUSTON
, TX
, 77005-2153
Practice Phone
: 713-662-2777;
Practice Fax
: 713-665-6227
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