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General NPI Number Information
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NPI Number | 1093169377
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Entity Type | Organization
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Legal Business Name | MIDWEST REGIONAL MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 2825 PARKLAWN DR
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City | MIDWEST CITY
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State | OK
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Zip | 73110-4201
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Country | US
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Telephone | 405-610-8147
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 405970
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City | ATLANTA
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State | GA
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Zip | 30384-5970
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Country | US
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Telephone | 405-610-8147
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | PAULA LALOR
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Credential |
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Telephone | 615-925-4565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 2293
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License Number State | OK
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