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General NPI Number Information
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NPI Number | 1255541777
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Entity Type | Organization
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Legal Business Name | WEST GROVE HOSPITAL CORPORATION
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 1015 W BALTIMORE PIKE
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City | WEST GROVE
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State | PA
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Zip | 19390-9459
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Country | US
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Telephone | 615-467-7871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 503773
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City | SAINT LOUIS
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State | MO
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Zip | 63150-0001
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Country | US
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Telephone | 615-467-7871
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Fax |
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Authorized Official
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Title or Position | PRESIDENT GROUP OPERATIONS
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Name | GARY NEWSOME
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Credential |
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Telephone | 615-465-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 291501
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 291501
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License Number State | PA
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