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General NPI Number Information
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NPI Number | 1982634572
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Entity Type | Organization
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Legal Business Name | GWINNETT HOSPITAL SYSTEM, INC.
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 250 SCENIC HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-5675
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Country | US
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Telephone | 678-442-5622
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Fax | 770-339-3459
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Provider Business Mailing Address
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Address Line | PO BOX 1190
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-1190
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Country | US
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Telephone | 678-442-5622
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Fax | 770-339-3459
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Authorized Official
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Title or Position | SR. VP., CHIEF FINANCIAL OFFICER
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Name | MR. THOMAS Y MCBRIDE III
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Credential |
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Telephone | 678-442-4308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 067-460
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License Number State | GA
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