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General NPI Number Information
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NPI Number | 1225849185
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Entity Type | Organization
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Legal Business Name | WEST GEORGIA MEDICAL CENTER, INC
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Dates
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Enumeration Date | 01/18/2025
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 1514 VERNON RD
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City | LAGRANGE
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State | GA
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Zip | 30240-4131
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Country | US
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Telephone | 470-644-0328
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Fax |
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Provider Business Mailing Address
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Address Line | 793 SAWYER RD
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City | MARIETTA
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State | GA
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Zip | 30062-2222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXEC. DIRECTOR REIMBURSEMENT
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Name | MR. EBENEZER ERZUAH
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Credential |
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Telephone | 470-956-4981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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