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General NPI Number Information
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NPI Number | 1871811257
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Entity Type | Organization
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Legal Business Name | HILLSIDE ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 250 FAME AVE SUITE 240
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City | HANOVER
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State | PA
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Zip | 17331-1587
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Country | US
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Telephone | 717-633-9086
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Fax | 717-633-9379
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Provider Business Mailing Address
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Address Line | 250 FAME AVE SUITE 240
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City | HANOVER
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State | PA
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Zip | 17331-1587
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Country | US
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Telephone | 717-633-9086
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Fax | 717-633-9379
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL THOMAS
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Credential | M.D.
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Telephone | 717-633-9086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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