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General NPI Number Information
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NPI Number | 1316097082
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Entity Type | Organization
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Legal Business Name | ROANOKE HEALTHCARE AUTHORITY
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 MEDICAL DR SUITE 7
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City | ROANOKE
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State | AL
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Zip | 36274-2421
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Country | US
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Telephone | 334-863-2311
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Fax | 334-863-5596
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Provider Business Mailing Address
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Address Line | PO BOX 473
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City | ROANOKE
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State | AL
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Zip | 36274-0473
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Country | US
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Telephone | 334-863-2311
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Fax | 334-863-5596
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY HARLIN
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Credential |
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Telephone | 334-863-4111
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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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