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General NPI Number Information
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NPI Number | 1306494844
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Entity Type | Organization
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Legal Business Name | MARY IMOGENE BASSETT HOSPITAL
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 28650 ROUTE 23
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City | STAMFORD
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State | NY
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Zip | 12167-1718
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Country | US
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Telephone | 607-652-2537
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Fax | 607-652-2719
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Provider Business Mailing Address
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Address Line | 1 ATWELL RD
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City | COOPERSTOWN
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State | NY
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Zip | 13326-1301
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Country | US
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Telephone | 607-652-2537
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Fax | 607-652-2719
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Authorized Official
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Title or Position | NETWORK CFO AND BMC VP
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Name | PAUL SWINKO
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Credential |
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Telephone | 607-547-3096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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