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General NPI Number Information
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NPI Number | 1760799415
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Entity Type | Organization
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Legal Business Name | SOUTHERN OHIO MEDICAL CENTER
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 1121 KINNEYS LN
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2806
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Country | US
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Telephone | 740-356-7461
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Fax | 740-356-7488
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Provider Business Mailing Address
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Address Line | 8635 STATE ROUTE 139
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City | MINFORD
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State | OH
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Zip | 45653-9000
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Country | US
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Telephone | 740-354-2989
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Fax | 740-356-7488
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. STEPHANIE LEAH CRAFT
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Credential | LSW/MSW
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Telephone | 740-356-7461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | S 0700732
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License Number State | OH
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