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General NPI Number Information
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NPI Number | 1982151866
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Entity Type | Individual
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Provider Name | SALLY HAISLIP RPH
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Gender | Female
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 1835 SAVOY DR SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30341-1072
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Country | US
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Telephone | 770-496-9457
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Fax | 770-496-9497
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Provider Business Mailing Address
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Address Line | 4662 LUCERNE VALLEY RD SW
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City | LILBURN
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State | GA
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Zip | 30047-4416
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Country | US
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Telephone | 770-978-9499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 11693
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 20258
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License Number State | GA
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