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General NPI Number Information
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NPI Number | 1083264543
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Entity Type | Organization
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Legal Business Name | PARADIGM WEST LLC
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 2110 RESEARCH ROW STE 100
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City | DALLAS
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State | TX
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Zip | 75235-2520
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Country | US
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Telephone | 912-342-2443
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Fax | 912-342-2446
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Provider Business Mailing Address
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Address Line | 249 REDFERN VLG
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City | SAINT SIMONS ISLAND
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State | GA
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Zip | 31522-2536
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Country | US
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Telephone | 912-342-2443
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Fax | 912-342-2446
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Authorized Official
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Title or Position | CEO
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Name | CATHERINE VEAL
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Credential |
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Telephone | 912-222-2804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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