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General NPI Number Information
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NPI Number | 1164779104
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Entity Type | Organization
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Legal Business Name | MEADOWS REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 11700 MERCY BLVD PLAZA D SUITE B
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City | SAVANNAH
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State | GA
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Zip | 31419-1798
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Country | US
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Telephone | 912-961-8642
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEADOWS PKWY
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City | VIDALIA
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State | GA
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Zip | 30474-8759
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Country | US
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Telephone | 912-538-5826
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Fax |
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Authorized Official
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Title or Position | CFO - VP OF FINANCE
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Name | MR. JOHN R CORNELL
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Credential |
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Telephone | 912-537-5826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | GA977-1
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License Number State | GA
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