{
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"OrgName": "SOUTHERN URGENT TRANSPORT LLC",
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"FirstLineMailingAddress": "216 LABONTE ST.",
"SecondLineMailingAddress": "SUITE D",
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"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29526",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-349-0086",
"MailingAddressFaxNumber": "843-349-0093",
"FirstLinePracticeLocationAddress": "216 LABONTE ST.",
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"PracticeLocationAddressTelephoneNumber": "843-349-0086",
"PracticeLocationAddressFaxNumber": "843-349-0093",
"EnumerationDate": "06/14/2012",
"LastUpdateDate": "06/14/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MURADOV",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "843-349-0086",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Land Ambulance",
"LicenseNumber": "317",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}