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General NPI Number Information
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NPI Number | 1982800967
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Entity Type | Organization
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Legal Business Name | BERWICK HOSPITAL CORPORATION
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 E 16TH ST
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City | BERWICK
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State | PA
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Zip | 18603-2440
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Country | US
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Telephone | 570-759-5000
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Fax | 570-759-3473
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Provider Business Mailing Address
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Address Line | P O BOX 503171
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City | ST LOUIS
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State | MO
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Zip | 63150-3171
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Country | US
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Telephone | 570-759-5000
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Fax | 570-759-3473
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY D NEWSOME
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Credential |
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Telephone | 615-465-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 281102
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License Number State | PA
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