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General NPI Number Information
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NPI Number | 1629058094
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 23 MASON ST
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City | LAUREL
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State | MS
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Zip | 39440-4437
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Country | US
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Telephone | 601-399-0528
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Fax | 601-425-7541
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Provider Business Mailing Address
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Address Line | PO BOX 869
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City | LAUREL
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State | MS
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Zip | 39441-0869
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Country | US
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Telephone | 601-399-0528
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Fax | 601-425-7541
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Authorized Official
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Title or Position | OPERATIONS COORDINATOR
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Name | MR. RORY M. DILL
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Credential |
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Telephone | 601-399-0528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 160
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License Number State | MS
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