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General NPI Number Information
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NPI Number | 1538374665
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Entity Type | Organization
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Legal Business Name | MEDAID, INC.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 527 E LONG AVE
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City | NEW CASTLE
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State | PA
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Zip | 16101-4843
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Country | US
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Telephone | 724-654-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 573 S MARKET ST
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City | NEW WILMINGTON
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State | PA
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Zip | 16142-1307
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Country | US
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Telephone | 724-946-9631
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Fax |
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | MR. MARK NAVYAC
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Credential | P.T.
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Telephone | 724-654-4545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | OC006255L
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License Number State | PA
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