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General NPI Number Information
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NPI Number | 1598975013
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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 | 05/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 675 N 5TH STREET
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City | LEBANON
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State | OR
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Zip | 97355-2875
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Country | US
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Telephone | 541-451-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 675 N 5TH STREET
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City | LEBANON
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State | OR
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Zip | 97355-2875
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Country | US
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Telephone | 541-451-6410
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH M. CAHILL
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Credential |
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Telephone | 541-557-6441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RP0000814
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License Number State | OR
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