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General NPI Number Information
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NPI Number | 1639140445
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Entity Type | Organization
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Legal Business Name | LORIS COMMUNITY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 3655 MITCHELL STREET
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City | LORIS
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State | SC
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Zip | 29569-9601
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Country | US
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Telephone | 843-716-7596
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Fax | 843-716-7093
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Provider Business Mailing Address
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Address Line | 3655 MITCHELL ST, BOX 690001
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City | LORIS
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State | SC
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Zip | 29569-9601
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Country | US
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Telephone | 843-716-7596
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Fax | 843-716-7093
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Authorized Official
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Title or Position | SR VP CFO
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Name | MR. FRED O TODD
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Credential |
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Telephone | 843-716-7271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | HTL033
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License Number State | SC
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