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General NPI Number Information
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NPI Number | 1851288286
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Entity Type | Organization
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Legal Business Name | SHP PROVIDER NETWORK, LLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 7505 WATERS AVE STE F9
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City | SAVANNAH
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State | GA
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Zip | 31406-3822
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Country | US
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Telephone | 912-691-5711
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60969
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City | SAVANNAH
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State | GA
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Zip | 31420-0969
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Country | US
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Telephone | 912-691-5711
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Fax |
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Authorized Official
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Title or Position | VP, MANAGED CARE
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Name | MS. KELLY MOONEY
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Credential |
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Telephone | 229-407-0213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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