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General NPI Number Information
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NPI Number | 1992773873
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Entity Type | Organization
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Legal Business Name | HARRISBURG MEDICAL CENTER INC
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 1007 US ROUTE 45
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City | ELDORADO
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State | IL
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Zip | 62930
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Country | US
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Telephone | 618-273-7723
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Fax | 618-273-3384
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Provider Business Mailing Address
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Address Line | PO BOX 250
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City | ELDORADO
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State | IL
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Zip | 62930-0250
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Country | US
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Telephone | 618-273-7723
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Fax | 618-273-3384
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. RODNEY D SMITH
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Credential |
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Telephone | 618-253-7671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0000521
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License Number State | IL
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