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General NPI Number Information
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NPI Number | 1437178647
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Entity Type | Organization
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Legal Business Name | PUTNAM COUNTY HOSPITAL
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 1609 LAFAYETTE RD
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1032
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Country | US
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Telephone | 765-364-0363
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Fax | 765-362-2436
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Provider Business Mailing Address
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Address Line | 1609 LAFAYETTE RD
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1032
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Country | US
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Telephone | 765-364-0363
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Fax | 765-362-2436
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Authorized Official
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Title or Position | CEO
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Name | DENNIS WEATHERFORD
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Credential |
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Telephone | 765-655-2620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 14-000162-1
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License Number State | IN
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