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General NPI Number Information
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NPI Number | 1316119654
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 60101 BODNER DR
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City | MISHAWAKA
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State | IN
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Zip | 46544-9339
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Country | US
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Telephone | 574-252-0300
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Fax | 574-252-0303
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Provider Business Mailing Address
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Address Line | 420 W 4TH ST
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City | MISHAWAKA
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State | IN
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Zip | 46544-1948
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Country | US
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Telephone | 574-252-0300
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Fax | 574-252-0303
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. STEVEN ROSE
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Credential |
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Telephone | 574-258-1293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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