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General NPI Number Information
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NPI Number | 1376358820
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Entity Type | Organization
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Legal Business Name | MID VALLEY HEALTHCARE INC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 525 N SANTIAM HWY
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City | LEBANON
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State | OR
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Zip | 97355-4363
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Country | US
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Telephone | 541-258-2101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1189
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City | CORVALLIS
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State | OR
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Zip | 97339-1189
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Country | US
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Telephone | 541-768-4410
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Fax |
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Authorized Official
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Title or Position | CEO-SLCH
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Name | DANIEL RACKHAM
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Credential |
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Telephone | 541-451-7914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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