INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('362659620', 'W12024716', 'W12024716', 'ILCHIGSTD', 'Anointed Heallth Partners', 'Gregory', 'H', 'Smith', 'MD', 'Family Practice', '', '', NULL, 'O', '2315 E 93rd St Ste 440', 'Chicago', 'Cook', 'IL', '60617', '7737682535', '7733744079', '2315 E 93rd St Ste 440', 'Chicago', 'Cook', 'IL', '60617', '7737682535', '7733744079', 'CHIG1', 'CHIHCPCS13', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, 'Little Company of Mary Hospital', '', '', 'HCFA|UB|', '1992861918', 0, 'N', 0, '2013-04-03', NULL, NULL, 41.7262, -87.5678, NULL, NULL),
('043730379', 'W12023116', 'W12023116', 'TXDALSTD', 'Trophy Club Family Medicine', 'John', 'M', 'Zarosky', 'MD', 'Family Practice', 'Sports Medicine', '', NULL, 'O', '301 Trophy Lake Dr Ste 136', 'Roanoke', 'Denton', 'TX', '76262', '8174309111', '8174308911', '301 Trophy Lake Dr Ste 136', 'Roanoke', 'Denton', 'TX', '76262', '8174309111', '8174308911', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Regional Medical Center at Grapevine', NULL, '', '', 'HCFA|UB|', '1568626646', 0, 'N', 0, '2013-02-27', NULL, NULL, 33, -97.2065, NULL, NULL),
('751950880', 'W12023119', 'W12023119', 'TXDALSTD', 'Brett Thacker MD', 'Brett', 'M', 'Thacker', 'MD', 'Internal Medicine', '', '', NULL, 'O', '201 Ferris Ave Ste I', 'Waxahachie', 'Ellis', 'TX', '75165', '9729371613', '9729370891', '201 Ferris Ave Ste I', 'Waxahachie', 'Ellis', 'TX', '75165', '9729371613', '9729370891', 'DALLAS1', 'TXHCPC13', '', '0.00', '50.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Baylor Medical Center at Waxahachie', NULL, NULL, NULL, 'HCFA|UB|', '1679502538', 0, 'N', 0, '2013-05-28', NULL, NULL, 32.3877, -96.85, NULL, NULL),
('528987785', 'W12023120', 'W12023120', 'UT01', 'Alta View Sports Medicine Center ', 'Christian', 'L', 'Sybrowsky', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '9844 S 1300 E Ste 100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015719433', '8015725607', '9844 S 1300 E Ste 100', 'Sandy', 'Salt Lake', 'UT', '84094', '8015719433', '8015725607', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-12-11', '2014-04-30', 0, 0, 0, 'St Marks Hospital', '', '', '', 'HCFA|UB|', '1710099676', 0, 'N', 0, '2014-05-27', NULL, NULL, 40.5721, -111.853, NULL, NULL),
('452863167', 'W12023121', 'W12023121', 'TXDALSTD', 'Cumbre Medical Center', 'Leovares', '', 'Medez', 'MD', 'Internal Medicine', '', '', NULL, 'O', '710 E Centerville Rd', 'Garland', 'Dallas', 'TX', '75041', '9729053520', '9722783485', '710 E Centerville Rd', 'Garland', 'Dallas', 'TX', '75041', '9729053520', '9722783485', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', '2030-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1760445936', 0, 'N', 1, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('760596382', 'W12023122', 'W12023122', 'TXHOUSTD', 'Jesus Beltran', 'Jesus', '', 'Beltran', 'MD', 'General Practice', '', '', NULL, 'O', '11605 Spring Cypress Rd Ste A', 'Tomball', 'Harris', 'TX', '77377', '2813571890', '2813515032', '11605 Spring Cypress Rd Ste A', 'Tomball', 'Harris', 'TX', '77377', '2813571890', '2813515032', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811044126', 0, 'N', 0, '2013-02-27', NULL, NULL, 30.0129, -95.5989, NULL, NULL),
('870500059', 'W12023123', 'W12023123', 'UT01', 'American Fork Vision Care', 'Craig', 'A', 'Pew', 'OD', 'Optometry', '', '', NULL, 'O', '24 W Main', 'American Fork', 'Utah', 'UT', '84003', '8017567996', '8017561690', '24 W Main', 'American Fork', 'Utah', 'UT', '84003', '8017567996', '8017561690', 'WUTALBERT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2012-10-02', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1821393810', 0, 'N', 0, '2014-02-25', NULL, NULL, 0, 0, NULL, NULL),
('412139554', 'W12023124', 'W12023124', 'TXHOUSTD', 'Houston Inpatient Group ', 'Cuong', '', 'Trinh', 'MD', 'Internal Medicine', '', '', NULL, 'O', '11720 W Airport Blvd Ste 300', 'Stafford', 'Fort Bend', 'TX', '77477', '2813026374', '2813026686', '11720 W Airport Blvd Ste 300', 'Stafford', 'Fort Bend', 'TX', '77477', '2813026374', '2813026686', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', '2030-01-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871537837', 0, 'N', 1, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('412139554', 'W12023125', 'W12023125', 'TXHOUSTD', 'Houston Inpatient Group ', 'Cuong', '', 'Trinh', 'MD', 'Internal Medicine', '', '', NULL, 'B', 'PO Box 298', 'Stafford', 'Fort Bend', 'TX', '77497', '2813026374', '2813026686', 'PO Box 298', 'Stafford', 'Fort Bend', 'TX', '77497', '2813026374', '2813026686', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871537837', 0, 'N', 1, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('481254491', 'W12023126', 'W12023126', 'TXHOUSTD', 'Reddy and Reynolds Cardiology', 'Kota', 'J', 'Reddy', 'MD PA', 'Cardiology', '', '', NULL, 'O', '3519 Town Ctr Blvd S Ste A', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814910044', '2814911447', '3519 Town Ctr Blvd S Ste A', 'Sugar Land', 'Fort Bend', 'TX', '77479', '2814910044', '2814911447', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891984043', 0, 'N', 0, '2013-02-27', NULL, NULL, 29.5874, -95.63, NULL, NULL),
('481254491', 'W12023127', 'W12023127', 'TXHOUSTD', 'Reddy and Reynolds Cardiology', 'Kota', 'J', 'Reddy', 'MD PA', 'Cardiology', '', '', NULL, 'M', 'PO Box 2566', 'Sugar Land', 'Fort Bend', 'TX', '77487', '2814910044', '2814911447', 'PO Box 2566', 'Sugar Land', 'Fort Bend', 'TX', '77487', '2814910044', '2814911447', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1891984043', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('371577951', 'W12023128', 'W12023128', 'NM01', '', 'Tommy', 'C', 'Larison', 'DC', 'Chiropractic', '', '', NULL, 'O', '1701 Moon St NE Ste 300', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5053232114', '5053329483', '1701 Moon St NE Ste 300', 'Albuquerque', 'Bernalillo', 'NM', '87112', '5053232114', '5053329483', 'NMCHIRO', 'WUSTDHCPC5', '', '0.00', '0.00', '38.00', 3, '2013-02-15', '2013-07-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902086416', 0, 'N', 0, '2013-05-29', NULL, NULL, 0, 0, NULL, NULL),
('760622153', 'W12023129', 'W12023129', 'TXHOUSTD', 'Quntao Yu MD', 'Quntao', '', 'Yu', 'MD', 'Pediatrics', '', '', NULL, 'O', '4427 Hwy 6 Ste J', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2815658188', '2815658184', '4427 Hwy 6 Ste J', 'Sugar Land', 'Fort Bend', 'TX', '77478', '2815658188', '2815658184', 'HOUSTON1', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Sugar Land Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1982603304', 0, 'N', 0, '2012-11-30', NULL, NULL, 29.5834, -95.5869, NULL, NULL),
('760263637', 'W12023130', 'W12023130', 'TXHOUSTD', 'Main Medical Group', 'Amin', 'H', 'Karim', 'MD', 'Cardiovascular Disease', '', '', NULL, 'O', '10021 S Main St Ste B1', 'Houston', 'Harris', 'TX', '77025', '7137979955', '7137979090', '10021 S Main St Ste B1', 'Houston', 'Harris', 'TX', '77025', '7137979955', '7137979090', 'HOUSTON2', 'TXHCPC13', '', '0.00', '45.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Houston Methodist Hospital', NULL, '', '', 'HCFA|UB|', '1982690988', 0, 'N', 0, '2013-03-21', NULL, NULL, 29.6764, -95.4284, NULL, NULL),
('271365687', 'W12023131', 'W12023131', 'UTMH1', 'Salt Lake Behavioral Health', 'William', 'A', 'Forsyth', 'MD', 'Mental Health', 'Psychiatry', '', NULL, 'O', '3802 S 700 E', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012646000', '8012646070', '3802 S 700 E', 'Salt Lake City', 'Salt Lake', 'UT', '84106', '8012646000', '8012646070', 'SLBEHAVE', '', '', '0.00', '100.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Davis Hospital', '', '', '', 'HCFA', '1467440669', 0, 'N', 0, '2014-02-18', NULL, NULL, 40.6875, -111.871, NULL, NULL),
('870635889', 'W12023132', 'W12023132', 'UT01', 'Tooele Clinic Corp ', 'Samara ', '', 'Lazernick', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '196 E 2000 N Ste 107', 'Tooele', 'Tooele', 'UT', '84074', '4358433678', '0000000000', '196 E 2000 N Ste 107', 'Tooele', 'Tooele', 'UT', '84074', '4358433678', '0000000000', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-07-31', 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659532307', 0, 'N', 0, '2013-07-11', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W12023133', 'W12023133', 'UT01', 'Tooele Clinic Corp ', 'Samara ', '', 'Lazernick', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'M', 'PO Box 689022', 'Franklin', 'Williamson', 'TN', '37068', '4358433678', '0000000000', 'PO Box 689022', 'Franklin', 'Williamson', 'TN', '37068', '4358433678', '0000000000', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659532307', 0, 'N', 0, '2012-12-28', NULL, NULL, 0, 0, NULL, NULL),
('870635889', 'W12023134', 'W12023134', 'UT01', 'Tooele Clinic Corp ', 'Samara ', '', 'Lazernick', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 848416', 'Boston', 'Suffolk', 'MA', '02284', '6174021000', '6174021099', 'PO Box 848416', 'Boston', 'Suffolk', 'MA', '02284', '6174021000', '6174021099', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Mountain West Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1659532307', 0, 'N', 0, '2013-07-11', NULL, NULL, 0, 0, NULL, NULL),
('621762573', 'W12023135', 'W12023135', 'UT01', 'Castleview Physician Practices ', 'Wayne', 'E', 'Cox', 'MD', 'General Surgery', '', '', NULL, 'O', '945 W Hospital Dr Ste 3', 'Price', 'Carbon', 'UT', '84501', '4356379158', '0000000000', '945 W Hospital Dr Ste 3', 'Price', 'Carbon', 'UT', '84501', '4356379158', '0000000000', 'WISESTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-08-01', NULL, 0, 0, 0, 'Castleview Hospital', 'Castleview Hospital', NULL, NULL, 'HCFA|UB|', '1821215997', 0, 'N', 0, '2013-07-25', NULL, NULL, 39.6064, -110.834, NULL, NULL),
('742591869', 'TX0120772', 'TX0120772', 'TXSATSTD', 'Women Partners in OBGYN', 'Kristin', '', 'Brozena', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 1698', 'San Antonio', 'Bexar', 'TX', '78296', '2109461300', '2109461700', 'PO Box 1698', 'San Antonio', 'Bexar', 'TX', '78296', '2109461300', '2109461700', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962661090', 0, 'N', 0, '2012-09-21', NULL, NULL, 0, 0, NULL, NULL),
('850232628', 'W12023136', 'W12023136', 'NM01', 'Womens Specialists of NM', 'Seddah', 'B', 'Moya', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '4640 Jefferson Lane NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058436168', '5052479743', '4640 Jefferson Lane NE', 'Albuquerque', 'Bernalillo', 'NM', '87109', '5058436168', '5052479743', 'NMSWOMEN', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-05-23', '2013-06-30', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1023269651', 0, 'N', 0, '2013-06-26', NULL, NULL, 0, 0, NULL, NULL),
('742591869', 'TX0120771', 'TX0120771', 'TXSATSTD', 'Women Partners in OB-GYN', 'Kristin', '', 'Brozena', 'MD', 'Obstetrics and Gynecology', '', '', NULL, 'O', '502 Madison Oak Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78258', '2109461300', '2109461700', '502 Madison Oak Dr Ste 100', 'San Antonio', 'Bexar', 'TX', '78258', '2109461300', '2109461700', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-08-20', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1962661090', 0, 'N', 0, '2012-09-21', NULL, NULL, 29.6212, -98.4905, NULL, NULL),
('061506129', 'W12020927', 'W12020927', 'UT01', 'Wee Care Pediatrics', 'Roderick', 'D', 'Maxwell', 'PA', 'Pediatrics', '', '', NULL, 'M', '2086 N 1700 W Ste C', 'Layton', 'Davis', 'UT', '84041', '8017738644', '8019271591', '2086 N 1700 W Ste C', 'Layton', 'Davis', 'UT', '84041', '8017738644', '8019271591', 'WUSTDPEDE5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902967219', 0, 'N', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('061506129', 'W12020925', 'W12020925', 'UT01', 'Wee Care Pediatrics', 'Roderick', 'D', 'Maxwell', 'PA', 'Pediatrics', '', '', NULL, 'O', '4040 Midland Dr Ste 2', 'Roy', 'Weber', 'UT', '84067', '8017738644', '8017313280', '4040 Midland Dr Ste 2', 'Roy', 'Weber', 'UT', '84067', '8017738644', '8017313280', 'WUSTDPEDE5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902967219', 0, 'N', 0, '2014-07-21', NULL, NULL, 41.1899, -112.049, NULL, NULL),
('061506129', 'W12020923', 'W12020923', 'UT01', 'Wee Care Pediatrics', 'Roderick', 'D', 'Maxwell', 'PA', 'Pediatrics', '', '', NULL, 'O', '5991 S 3500 W Ste 100', 'Roy', 'Weber', 'UT', '84067', '8017738644', '8019850486', '5991 S 3500 W Ste 100', 'Roy', 'Weber', 'UT', '84067', '8017738644', '8019850486', 'WUSTDPEDE5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902967219', 0, 'N', 0, '2014-07-21', NULL, NULL, 41.1545, -112.064, NULL, NULL),
('061506129', 'W12020922', 'W12020922', 'UT01', 'Wee Care Pediatrics', 'Roderick', 'D', 'Maxwell', 'PA', 'Pediatrics', '', '', NULL, 'O', '934 S Main St Ste 8', 'Layton', 'Davis', 'UT', '84041', '8017738644', '8015936188', '934 S Main St Ste 8', 'Layton', 'Davis', 'UT', '84041', '8017738644', '8015936188', 'WUSTDPEDE5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902967219', 0, 'N', 0, '2014-07-21', NULL, NULL, 41.0461, -111.953, NULL, NULL),
('061506129', 'W12020926', 'W12020926', 'UT01', 'Wee Care Pediatrics', 'Roderick', 'D', 'Maxwell', 'PA', 'Pediatrics', '', '', NULL, 'B', 'Dept 1310', 'Denver', 'Denver', 'CO', '80256', '8019271562', '8019271591', 'Dept 1310', 'Denver', 'Denver', 'CO', '80256', '8019271562', '8019271591', 'WUSTDPEDE5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902967219', 0, 'N', 0, '2014-07-21', NULL, NULL, 0, 0, NULL, NULL),
('752890546', 'W12021229', 'W12021229', 'NA01', 'Preferred Home Care', '', '', 'Park Infusion Care', '', 'Durable Medical Equipment', '', '', NULL, '', '8666 Huebner Rd Ste 208', 'San Antonio', 'Bexar', 'TX', '78240', '2106973800', '2106973801', '8666 Huebner Rd Ste 208', 'San Antonio', 'Bexar', 'TX', '78240', '2106973800', '2106973801', 'DME7012', '', '', '0.00', '35.00', '0.00', 3, '2012-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649415746', 0, 'Y', 0, '2012-10-03', NULL, NULL, 0, 0, NULL, NULL),
('752890546', 'W12021228', 'W12021228', 'TX01', 'Preferred Home Care', '', '', 'Park Infusion Care', '', 'Durable Medical Equipment', '', '', NULL, '', '8666 Huebner Rd Ste 208', 'San Antonio', 'Bexar', 'TX', '78240', '2106973800', '2106973801', '8666 Huebner Rd Ste 208', 'San Antonio', 'Bexar', 'TX', '78240', '2106973800', '2106973801', 'DME7012', '', '', '0.00', '35.00', '0.00', 3, '2012-08-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1649415746', 0, 'N', 0, '2012-10-03', NULL, NULL, 0, 0, NULL, NULL),
('260745445', 'W12023139', 'W12023139', 'NM01', '', 'Suzanne', '', 'Russell Thornberry', 'LISW', 'Mental Health', '', '', NULL, 'O', '901 Rio Grande Blvd NW Ste F244', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5053793703', '5055037280', '901 Rio Grande Blvd NW Ste F244', 'Albuquerque', 'Bernalillo', 'NM', '87105', '5053793703', '5055037280', '', '', '', '0.00', '0.00', '0.00', 3, '2012-09-19', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1841309838', 0, 'N', 0, '2012-09-21', NULL, NULL, 35.1026, -106.671, NULL, NULL),
('770701557', 'W12023140', 'W12023140', 'UT01', 'St Marks Hospital', 'Kathryn', '', 'Allen', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'O', '3540 S 4000 W Ste 340', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019690200', '8019690393', '3540 S 4000 W Ste 340', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019690200', '8019690393', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', '', '', '', 'HCFA|UB|', '1023058278', 0, 'N', 0, '2014-04-04', NULL, NULL, 40.6955, -111.987, NULL, NULL),
('770701557', 'W12023141', 'W12023141', 'UT01', 'St Marks Hospital', 'Kathryn', '', 'Allen', 'MD', 'Family Practice', 'Sports Medicine', NULL, NULL, 'B', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '6153737600', '0000000000', 'PO Box 198560', 'Atlanta', 'Fulton', 'GA', '30384', '6153737600', '0000000000', 'UTHCAPS', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', '', '', '', 'HCFA|UB|', '1023058278', 0, 'N', 0, '2014-04-04', NULL, NULL, 0, 0, NULL, NULL),
('383883336', 'W12023142', 'W12023142', 'UTMH1', '', 'Kelly', '', 'Morse', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '1092 E 255 S', 'Layton', 'Davis', 'UT', '84041', '8018153959', NULL, '1092 E 255 S', 'Layton', 'Davis', 'UT', '84041', '8018153959', '          ', 'ma', '', '', '0.00', '35.00', '0.00', 3, '2012-09-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1871774596', 0, 'N', 0, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('363771396', 'W12023143', 'W12023143', 'ID02', 'Overton Siff Professional Anesthesia Service', '', '', 'Overton Siff Professional Anesthesia Service', '', 'Anesthesia', '', '', NULL, 'B', 'PO Box 4893', 'Boise', 'Ada', 'ID', '83711', '2089393255', '2089392379', 'PO Box 4893', 'Boise', 'Ada', 'ID', '83711', '2089393255', '2089392379', '', '', '', '59.00', '35.00', '0.00', 3, '2030-01-01', NULL, 0, 15, 1, '', '', '', '', 'HCFA|UB|', '0000009910', 0, 'N', 0, '2012-10-19', NULL, NULL, 0, 0, NULL, NULL),
('830199236', 'W12023155', 'W12023155', 'WY01', 'Yellowstone Behavioral Health Center', 'Jacqueline', '', 'Evans McAlister', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', NULL, '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', '          ', 'ma', '', '', '0.00', '35.00', '0.00', 3, '2013-01-01', '2013-02-14', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902072630', 0, 'N', 0, '2012-12-28', NULL, NULL, 0, 0, NULL, NULL),
('830199236', 'W12023156', 'W12023156', 'WYT1', 'Yellowstone Behavioral Health Center', 'Jacqueline', '', 'Evans McAlister', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', NULL, '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', '          ', 'ma', '', '', '0.00', '35.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1902072630', 0, 'N', 0, '2013-07-24', NULL, NULL, 0, 0, NULL, NULL),
('391355038', 'W12023157', 'W12023157', 'ILCHIGSTD', 'Dante P Gabriel, MD SC', 'Marson', '', 'Tenoso', 'MD', 'Pediatrics', '', '', NULL, 'O', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1891944666', 0, 'N', 0, '2013-09-04', NULL, NULL, 42.359, -87.8996, NULL, NULL),
('391355038', 'W12023158', 'W12023158', 'ILCHIGSTD', 'Dante P Gabriel, MD SC', 'Faye', '', 'Samonte', 'MD', 'Pediatrics', '', '', NULL, 'O', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1811085053', 0, 'N', 0, '2013-04-16', NULL, NULL, 42.359, -87.8996, NULL, NULL),
('870373083', 'W12023164', 'W12023164', 'UT01', 'Heart and Lung Institute of Utah', 'Navin', 'S', 'Thakur', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'O', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3336 S 4155 W Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639146566', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('870373083', 'W12023165', 'W12023165', 'UT01', 'Heart and Lung Institute of Utah', 'Navin', 'S', 'Thakur', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639146566', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.588, -111.975, NULL, NULL),
('870373083', 'W12023162', 'W12023162', 'UT01', 'Heart and Lung Institute of Utah', 'Navin', 'S', 'Thakur', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639146566', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.6415, -111.883, NULL, NULL),
('830199236', 'W12023177', 'W12023177', 'WY01', 'Yellowstone Behavioral Health Center', 'Kristi', '', 'Zola', 'LPC', 'Mental Health', 'Counseling', '', NULL, 'O', '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', NULL, '2538 Big Horn Ave', 'Cody', 'Park', 'WY', '82414', '3075872197', '          ', 'MA', '', '', '0.00', '40.00', '0.00', 6, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1437442639', 0, 'N', 0, '2013-07-12', NULL, NULL, 44.5334, -109.04, NULL, NULL),
('391355038', 'W12023179', 'W12023179', 'ILCHIGSTD', 'Dante P Gabriel, MD SC', 'Alma', '', 'Guzman', 'MD', 'Pediatrics', '', '', NULL, 'O', '1324 N Sheridan Rd', 'Waukegan', 'Lake', 'IL', '60085', '8476234464', '8476239984', '1324 N Sheridan Rd', 'Waukegan', 'Lake', 'IL', '60085', '8476234464', '8476239984', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366530503', 0, 'N', 0, '2013-04-16', NULL, NULL, 42.3783, -87.831, NULL, NULL),
('870373083', 'W12023163', 'W12023163', 'UT01', 'Heart and Lung Institute of Utah', 'Navin', 'S', 'Thakur', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639146566', 0, 'N', 0, '2012-10-12', NULL, NULL, 0, 0, NULL, NULL),
('270968062', 'W12023167', 'W12023167', 'UTMH1', 'The Counseling Center', 'Victoria', '', 'Winsett', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'B', '123 W 1550 N', 'Bountiful', 'Davis', 'UT', '84010', '8012982000', '8019511490', '123 W 1550 N', 'Bountiful', 'Davis', 'UT', '84010', '8012982000', '8019511490', 'ma', '', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2012-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629352117', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('270968062', 'W12023166', 'W12023166', 'UTMH1', 'The Counseling Center', 'Victoria', '', 'Winsett', 'LCSW', 'Mental Health', 'Social Worker', '', NULL, 'O', '386 N Main St', 'Centerville', 'Davis', 'UT', '84014', '8012982000', '8019511490', '386 N Main St', 'Centerville', 'Davis', 'UT', '84014', '8012982000', '8019511490', 'ma', '', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2012-11-01', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1629352117', 0, 'N', 0, '2013-09-23', NULL, NULL, 0, 0, NULL, NULL),
('363562276', 'W12023228', 'W12023228', 'ILCHIGSTD', 'Dolton Medical Group', 'Harivadan', '', 'Gandhi', 'MD', 'Pediatrics', '', '', NULL, 'O', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164525499', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.6227, -87.5705, NULL, NULL),
('391355038', 'W12023168', 'W12023168', 'ILCHIGSTD', '', 'Dante', 'P', 'Gabriel', 'MD', 'Pediatrics', '', '', NULL, 'O', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1568569754', 0, 'N', 0, '2013-04-26', NULL, NULL, 42.359, -87.8996, NULL, NULL),
('870373083', 'W12023173', 'W12023173', 'UT01', 'Heart and Lung Institute', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'O', '3336 S 4155 W  Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', '3336 S 4155 W  Ste 203', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('870373083', 'W12023174', 'W12023174', 'UT01', 'Heart and Lung Institute', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'O', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', '3570 W 9000 S Ste 110', 'West Jordan', 'Salt Lake', 'UT', '84088', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.588, -111.975, NULL, NULL),
('870373083', 'W12023171', 'W12023171', 'UT01', 'Heart and Lung Institute of Utah', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'O', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', '5979 S Fashion Blvd', 'Murray', 'Salt Lake', 'UT', '84107', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.6415, -111.883, NULL, NULL),
('870373083', 'W12023175', 'W12023175', 'UT01', 'Heart and Lung Institute of Utah', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'O', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.7676, -111.86, NULL, NULL),
('870373083', 'W12023172', 'W12023172', 'UT01', 'Heart and Lung Institute', 'James', 'C', 'Stringham', 'MD', 'Cardiovascular Disease', 'Pulmonary', NULL, NULL, 'B', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'PO Box 847112', 'Dallas', 'Dallas', 'TX', '75284', '8012632370', '8012651200', 'WUUTCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1538182449', 0, 'N', 0, '2012-10-12', NULL, NULL, 0, 0, NULL, NULL),
('870373083', 'W12023176', 'W12023176', 'UT01', 'Heart and Lung Institute of Utah', 'Navin', 'S', 'Thakur', 'MD', 'Cardiovascular Disease', 'Thoracic Surgery', 'Vascular Surgery', NULL, 'O', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', '82 S 1100 E Ste 103', 'Salt Lake City', 'Salt Lake', 'UT', '84102', '8012632370', '8012651200', 'WUSTDCARD5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-11-01', '2014-04-30', 0, 0, 0, 'Salt Lake Regional Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1639146566', 0, 'N', 0, '2012-10-12', NULL, NULL, 40.7676, -111.86, NULL, NULL),
('391355038', 'W12023178', 'W12023178', 'ILCHIGSTD', 'Dante P Gabriel, MD SC', 'Alma', '', 'Guzman', 'MD', 'Pediatrics', '', '', NULL, 'O', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', '15 Tower Ct Ste 150', 'Gurnee', 'Lake', 'IL', '60031', '8476234464', '8476239984', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-02-15', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366530503', 0, 'N', 0, '2013-04-16', NULL, NULL, 42.359, -87.8996, NULL, NULL),
('363562276', 'W12023229', 'W12023229', 'ILCHIGSTD', 'Dolton Medical Group', 'Harivadan', '', 'Gandhi', 'MD', 'Pediatrics', '', '', NULL, 'B', '143 Silo Ridge Rd N', 'Orland Park', 'Cook', 'IL', '60467', '7088682300', '7088682304', '143 Silo Ridge Rd N', 'Orland Park', 'Cook', 'IL', '60467', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1164525499', 0, 'N', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12023182', 'W12023182', 'UT01', 'Central Utah Clinic PC', 'Michelle', '', 'Grubb', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', '1886 W 800 N', 'Pleasant Grove', 'Utah', 'UT', '84062', '8017565288', '8017567589', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2013-04-01', '2014-07-13', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB', '1467708487', 0, 'N', 0, '2014-06-30', NULL, NULL, 40.3722, -111.769, NULL, NULL),
('870281028', 'W12023183', 'W12023183', 'UT01', 'Central Utah Clinic PC', 'Michelle', '', 'Grubb', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2013-04-01', '2014-07-13', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB', '1467708487', 0, 'N', 0, '2014-06-30', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12023184', 'W12023184', 'UT01', 'Central Utah Clinic PC', 'Michelle', '', 'Grubb', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'M', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014180941', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014180941', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2013-04-01', '2014-07-13', 0, 0, 0, 'Timpanogos Regional Hospital', '', '', '', 'HCFA|UB', '1467708487', 0, 'N', 0, '2014-06-30', NULL, NULL, 0, 0, NULL, NULL),
('830326307', 'W12023185', 'W12023185', 'WY01', 'Community Health Center of Central Wyoming', 'Gabriele', '', 'Knierim', 'MD', 'Family Practice', '', '', NULL, 'O', '5000 Blackmore Rd', 'Casper', 'Natrona', 'WY', '82609', '3072336000', '3072336089', '5000 Blackmore Rd', 'Casper', 'Natrona', 'WY', '82609', '3072336000', '3072336089', 'WISEWYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366420499', 0, 'N', 0, '2013-04-15', NULL, NULL, 42.8286, -106.293, NULL, NULL),
('830326307', 'W12023186', 'W12023186', 'WYT1', 'Community Health Center of Central Wyoming', 'Gabriele', '', 'Knierim', 'MD', 'Family Practice', '', '', NULL, 'O', '5000 Blackmore Rd', 'Casper', 'Natrona', 'WY', '82609', '3072336000', '3072336089', '5000 Blackmore Rd', 'Casper', 'Natrona', 'WY', '82609', '3072336000', '3072336089', 'WISEWYSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-05-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1366420499', 0, 'N', 0, '2013-04-15', NULL, NULL, 0, 0, NULL, NULL),
('680516959', 'W12023187', 'W12023187', 'UT01', 'West Valley Vision Source', 'Paul', 'C', 'Bruderer', 'OD', 'Optometry', '', '', NULL, 'O', '2782 S 5600 W Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019699999', '8017461007', '2782 S 5600 W Ste 101', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8019699999', '8017461007', 'WUTALBERT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-09-21', NULL, 0, 0, 0, 'Davis Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316956576', 0, 'N', 0, '2014-01-17', NULL, NULL, 40.7095, -112.025, NULL, NULL),
('850275777', 'W12023188', 'W12023188', 'NM01', 'Southwest Medical Associates', 'Sheila', '', 'Manhas', 'MD', 'Neurology', '', '', NULL, 'O', '4420 Irving Blvd NW', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', NULL, '4420 Irving Blvd NW', 'Albuquerque', 'Bernalillo', 'NM', '87114', '5058231010', '          ', 'NMSWMED', '', '', '0.00', '10.00', '0.00', 3, '2012-10-04', '2013-07-31', 0, 0, 0, 'Lovelace Medical Center', '', '', '', 'HCFA|UB|', '1174584965', 0, 'N', 0, '2013-06-20', NULL, NULL, 0, 0, NULL, NULL),
('870616107', 'W12023189', 'W12023189', 'UT01', 'U of U Hospitals and Clinics', '', '', 'U of U Hospitals and Clinics', 'GROUP', 'Family Practice', 'Optometry', 'Internal Medicine', NULL, 'B', 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8012133900', NULL, 'PO Box 510708', 'Salt Lake City', 'Salt Lake', 'UT', '84151', '8012133900', '          ', 'WUNIVOP', 'WUSTDHCPC5', '', '0.00', '25.00', '0.00', 6, '2012-09-16', '2012-09-16', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009233', 0, 'N', 0, '2013-12-12', NULL, NULL, 0, 0, NULL, NULL),
('870284475', 'W12023190', 'W12023190', 'UT01', 'Granger Medical Clinic West Jordan', 'Jeffrey', 'G', 'Miles', 'MD', 'Family Practice', NULL, NULL, NULL, 'O', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', 'WUGRANGER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-09-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1952399966', 0, 'N', 0, '2012-09-24', NULL, NULL, 40.5877, -111.967, NULL, NULL),
('870284475', 'W12023191', 'W12023191', 'UT01', 'Granger Medical Clinic West Jordan', 'Steve ', 'A', 'Oliver', 'MD', 'Urgent Care', '', '', NULL, 'O', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', 'WUGRANGER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-09-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', '', '', '', 'HCFA|UB|', '1396720058', 0, 'N', 0, '2014-07-25', NULL, NULL, 40.5877, -111.967, NULL, NULL),
('870284475', 'W12023192', 'W12023192', 'UT01', 'Granger Medical Clinic West Jordan', 'Easton', 'D', 'Jackson', 'MD', 'Urgent Care', '', '', NULL, 'O', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', '3181 W 9000 S', 'West Jordan', 'Salt Lake', 'UT', '84088', '8013525900', '8013525914', 'WUGRANGER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-09-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1316049828', 0, 'N', 0, '2014-01-17', NULL, NULL, 40.5877, -111.967, NULL, NULL),
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('870284475', 'W12011779', 'W12011779', 'UT01', 'Granger Medical Clinic', 'Erica', 'N', 'Baiden', 'MD', 'Family Practice', '', '', NULL, 'B', 'PO Box 70658', 'Salt Lake City', 'Salt Lake', 'UT', '84170', '8019653600', '8019683605', 'PO Box 70658', 'Salt Lake City', 'Salt Lake', 'UT', '84170', '8019653600', '8019683605', 'WUGRANGER5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2011-10-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1821242108', 0, 'N', 0, '2012-10-09', NULL, NULL, 0, 0, NULL, NULL),
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('352020416', 'W12023231', 'W12023231', 'ILCHIGSTD', 'Dolton Medical Group', '', '', 'Dolton Medical Group', '', 'Clinics', '', '', NULL, 'B', '1542 Melbrook Dr', 'Munster', 'Lake', 'IN', '46321', '7088682300', '7088682304', '1542 Melbrook Dr', 'Munster', 'Lake', 'IN', '46321', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009956', 0, 'Y', 0, '2013-03-25', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0000001', 'RX0000001', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', 'SWC POLE LINE AND WASHINGTON', 'TWIN FALLS', 'Twin Falls', 'ID', '83301', '2087363387', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1417190315', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('161697626', 'W12023237', 'W12023237', 'ID02', 'Snake River Dermatology', 'Brock', '', 'Andersen', 'MD', 'Dermatology', '', '', NULL, 'O', '1611 N Whitley Dr Ste 7', 'Fruitland', 'Payette', 'ID', '83619', '2084525999', '2084524499', '1611 N Whitley Dr Ste 7', 'Fruitland', 'Payette', 'ID', '83619', '2084525999', '2084524499', 'IDACN', '', '', '0.00', '15.00', '0.00', 3, '2012-08-02', '2013-06-30', 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1558349852', 0, 'Y', 0, '2013-07-12', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('742915297', 'W12023239', 'W12023239', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Sylvia', 'G', 'Zubyk', 'MD', 'Radiation Oncology', '', '', NULL, 'O', '4383 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', NULL, '4383 Medical Dr', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', '          ', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-09-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972500197', 0, 'N', 0, '2013-11-21', NULL, NULL, 29.511, -98.5709, NULL, NULL),
('742915297', 'W12023240', 'W12023240', 'TXSATSTD', 'South Texas Oncology and Hematology', 'Sylvia', 'G', 'Zubyk', 'MD', 'Radiation Oncology', '', '', NULL, 'B', 'Po Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', NULL, 'Po Box 268', 'San Antonio', 'Bexar', 'TX', '78229', '2105935700', '          ', 'TXONCOL', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-09-20', NULL, 0, 0, 0, 'North East Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1972500197', 0, 'N', 0, '2013-11-21', NULL, NULL, 0, 0, NULL, NULL),
('261129205', 'W12023242', 'W12023242', 'ILCHIGSTD', 'Chaden Sbai MD', 'Chaden', '', 'Sbai', '', 'Internal Medicine', '', '', NULL, 'O', '6703 W 159th St', 'Tinley Park', 'Cook', 'IL', '60477', '7084448593', '7084442673', '6703 W 159th St', 'Tinley Park', 'Cook', 'IL', '60477', '7084448593', '7084442673', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1992704100', 0, 'N', 1, '2013-05-31', NULL, NULL, 41.6024, -87.7821, NULL, NULL),
('561599929', 'W12023219', 'W12023219', 'ILCHIGSTD', 'Dolton Medical Group', 'Rama', '', 'Medavaram', 'MD', 'Family Practice', '', '', NULL, 'O', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB', '1780780114', 0, 'N', 0, '2013-08-01', NULL, NULL, 41.6227, -87.5705, NULL, NULL),
('364475112', 'W12023244', 'W12023244', 'ILCHIGSTD', 'Park West Family Physicians', 'Kew Jung', '', 'Lee', 'MD', 'Family Practice', '', '', NULL, 'B', '350 S Northwest Hwy Ste 200', 'Park Ridge', 'Cook', 'IL', '60068', '7732813563', '7738806107', '350 S Northwest Hwy Ste 200', 'Park Ridge', 'Cook', 'IL', '60068', '7732813563', '7738806107', 'CHIG1', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-01-01', 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, NULL, NULL, 'HCFA|UB|', '1669463618', 0, 'N', 0, '2013-06-06', NULL, NULL, 0, 0, NULL, NULL),
('364475112', 'W12023243', 'W12023243', 'ILCHIGSTD', 'Park West Family Physicians', 'Kew Jung', '', 'Lee', 'MD', 'Family Practice', '', '', NULL, 'O', '830 W Diversey Pkwy', 'Chicago', 'Cook', 'IL', '60614', '7732813563', '7738806107', '830 W Diversey Pkwy', 'Chicago', 'Cook', 'IL', '60614', '7732813563', '7738806107', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Hospital Chicago', NULL, NULL, NULL, 'HCFA|UB|', '1669463618', 0, 'N', 0, '2013-06-06', NULL, NULL, 41.9327, -87.6502, NULL, NULL),
('364440222', 'W12023245', 'W12023245', 'ILCHIGSTD', 'Martinez Medical Services', 'Maria', 'Glendale', 'Martinez', '', 'Internal Medicine', '', '', NULL, 'O', '802 E Woodfield Rd Ste 300', 'Schaumburg', 'Cook', 'IL', '60173', '8472409300', '8474855014', '802 E Woodfield Rd Ste 300', 'Schaumburg', 'Cook', 'IL', '60173', '8472409300', '8474855014', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1558335810', 0, 'N', 1, '2013-11-27', NULL, NULL, 0, 0, NULL, NULL),
('450927704', 'W12023246', 'W12023246', 'ILCHIGSTD', 'C Dean Katsamakis DO FACC SC', 'C Dean', '', 'Katsamakis', 'DO', 'Cardiology', 'Internal Medicine', '', NULL, 'O', '240 Waukegan', 'Glenview', 'Cook', 'IL', '60025', '8479047400', '8479047401', '240 Waukegan', 'Glenview', 'Cook', 'IL', '60025', '8479047400', '8479047401', 'CHIG2', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Resurrection Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407906100', 0, 'N', 0, '2013-04-26', NULL, NULL, 42.0598, -87.7997, NULL, NULL),
('450927704', 'W12023247', 'W12023247', 'ILCHIGSTD', 'C Dean Katsamakis DO FACC SC', 'C Dean', '', 'Katsamakis', 'DO', 'Cardiology', 'Internal Medicine', '', NULL, 'B', '3149 Dundee Rd Ste 290', 'Northbrook', 'Cook', 'IL', '60062', '8479047400', '8479047401', '3149 Dundee Rd Ste 290', 'Northbrook', 'Cook', 'IL', '60062', '8479047400', '8479047401', 'CHIG2', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Resurrection Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1407906100', 0, 'N', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('260506289', 'W12023248', 'W12023248', 'ILCHIGSTD', 'Illinois Foot and Ankle Clinic', 'Alexander', '', 'Yanovskiy', 'DPM', 'Podiatry', '', '', NULL, 'O', '1475 E Oakton St', 'Des Plaines', 'Cook', 'IL', '60018', '7736143302', '8479061092', '1475 E Oakton St', 'Des Plaines', 'Cook', 'IL', '60018', '7736143302', '8479061092', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295925899', 0, 'N', 1, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('260506289', 'W12023249', 'W12023249', 'ILCHIGSTD', 'Illinois Foot and Ankle Clinic', 'Alexander', '', 'Yanovskiy', 'DPM', 'Podiatry', '', '', NULL, 'O', '2500 W Higgins Rd Ste 910', 'Hoffman Estates', 'Cook', 'IL', '60169', '7736143302', '8479061092', '2500 W Higgins Rd Ste 910', 'Hoffman Estates', 'Cook', 'IL', '60169', '7736143302', '8479061092', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1295925899', 0, 'N', 1, '2013-02-27', NULL, NULL, 0, 0, NULL, NULL),
('208988912', 'W12023250', 'W12023250', 'ILCHIGSTD', 'Arlington Primary Care SC', 'Mamdouh', 'L', 'Ishak', 'MD', 'Internal Medicine', '', '', NULL, 'O', '121 S Wilke Rd Ste 110', 'Arlington Heights', 'Cook', 'IL', '60005', '8473984536', '8473984712', '121 S Wilke Rd Ste 110', 'Arlington Heights', 'Cook', 'IL', '60005', '8473984536', '8473984712', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Northwest Community Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1275612343', 0, 'N', 0, '2013-04-26', NULL, NULL, 42.0807, -88.0047, NULL, NULL),
('363595930', 'W12023251', 'W12023251', 'ILCHIGSTD', 'Robert Winiecki, MD', 'Robert', 'A', 'Winiecki', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1500 Eisenhower Ln Ste 700', 'Lisle', 'Dupage', 'IL', '60532', '6309641844', '6309641977', '1500 Eisenhower Ln Ste 700', 'Lisle', 'Dupage', 'IL', '60532', '6309641844', '6309641977', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Edward Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1215985155', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.7864, -88.0812, NULL, NULL),
('363216902', 'W12023252', 'W12023252', 'ILCHIGSTD', 'Surgical Practice', 'W', 'Gregory', 'Ward', 'MD', 'General Surgery', '', '', NULL, 'O', '1980 Three Farms Ave Ste 108', 'Naperville', 'Dupage', 'IL', '60540', '6305276300', '6305276307', '1980 Three Farms Ave Ste 108', 'Naperville', 'Dupage', 'IL', '60540', '6305276300', '6305276307', 'CHIG2', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Edward Hospital', NULL, '', '', 'HCFA|UB|', '1174622971', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.7494, -88.187, NULL, NULL),
('364120689', 'W12023254', 'W12023254', 'ILCHIGSTD', 'Leonard Stallings MD Associates', 'Leonard', '', 'Stallings', '', 'Internal Medicine', '', '', NULL, 'O', '5120 W Jackson Blvd', 'Chicago', 'Cook', 'IL', '60644', '7738874008', '7738844423', '5120 W Jackson Blvd', 'Chicago', 'Cook', 'IL', '60644', '7738874008', '7738844423', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053481176', 0, 'N', 1, '2013-02-20', NULL, NULL, 0, 0, NULL, NULL),
('364120689', 'W12023255', 'W12023255', 'ILCHIGSTD', 'Leonard Stallings MD Associates', 'Leonard', '', 'Stallings', '', 'Internal Medicine', '', '', NULL, 'M', 'PO Box 5128', 'River Forest', 'Cook', 'IL', '60305', '7738874008', '7738844423', 'PO Box 5128', 'River Forest', 'Cook', 'IL', '60305', '7738874008', '7738844423', '', '', '', '0.00', '0.00', '0.00', 3, '2030-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1053481176', 0, 'N', 1, '2013-02-20', NULL, NULL, 0, 0, NULL, NULL),
('271168572', 'W12023259', 'W12023259', 'ILCHIGSTD', 'Primary Care Services', '', '', 'Primary Care Services ', '', 'Clinics', '', '', NULL, 'O', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009950', 0, 'Y', 0, '2013-03-25', NULL, NULL, 41.846, -87.9782, NULL, NULL),
('271168572', 'W12023260', 'W12023260', 'ILCHIGSTD', 'Primary Care Services', '', '', 'Primary Care Services ', '', 'Clinics', '', '', NULL, 'O', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009950', 0, 'Y', 0, '2013-03-25', NULL, NULL, 41.9149, -88.0598, NULL, NULL),
('271168572', 'W12023264', 'W12023264', 'ILCHIGSTD', 'Primary Care Services', 'Iram', '', 'Ahmed', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, '', '', 'HCFA|UB|', '1639383631', 0, 'N', 0, '2013-03-25', NULL, NULL, 41.846, -87.9782, NULL, NULL),
('271168572', 'W12023265', 'W12023265', 'ILCHIGSTD', 'Primary Care Services', 'Iram', '', 'Ahmed', 'MD', 'Internal Medicine', '', '', NULL, 'O', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, '', '', 'HCFA|UB|', '1639383631', 0, 'N', 0, '2013-03-25', NULL, NULL, 41.9149, -88.0598, NULL, NULL),
('363165098', 'W12023221', 'W12023221', 'ILCHIGSTD', 'Dolton Medical Group', 'Pinakinprasad', 'K', 'Dave', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720196876', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.6227, -87.5705, NULL, NULL),
('363165098', 'W12023223', 'W12023223', 'ILCHIGSTD', 'Dolton Medical Group', 'Pinakinprasad', 'K', 'Dave', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1940 E 170th Pl', 'South Holland', 'Cook', 'IL', '60473', '7088682300', '7088682304', '1940 E 170th Pl', 'South Holland', 'Cook', 'IL', '60473', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720196876', 0, 'N', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('352020416', 'W12023226', 'W12023226', 'ILCHIGSTD', 'Dolton Medical Group', 'Prabhakar', 'J', 'Parikh', 'MD', 'Internal Medicine', '', '', NULL, 'B', '1542 Melbrook Dr', 'Munster', 'Lake', 'IN', '46321', '7088682300', '7088682304', '1542 Melbrook Dr', 'Munster', 'Lake', 'IN', '46321', '7088682300', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417067778', 0, 'Y', 0, '2013-04-26', NULL, NULL, 0, 0, NULL, NULL),
('352020416', 'W12023225', 'W12023225', 'ILCHIGSTD', 'Dolton Medical Group', 'Prabhakar', 'J', 'Parikh', 'MD', 'Internal Medicine', '', '', NULL, 'O', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682306', '7088682304', '1851 Sibley Blvd', 'Calumet City', 'Cook', 'IL', '60409', '7088682306', '7088682304', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1417067778', 0, 'N', 0, '2013-04-26', NULL, NULL, 41.6227, -87.5705, NULL, NULL),
('271168572', 'W12023266', 'W12023266', 'ILCHIGSTD', 'Primary Care Services', 'Meena', 'R', 'Krishna', 'MD', 'Internal Medicine', '', '', NULL, 'O', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215150479', 0, 'N', 0, '2014-01-31', NULL, NULL, 41.8453, -87.9782, NULL, NULL),
('271168572', 'W12023267', 'W12023267', 'ILCHIGSTD', 'Primary Care Services', 'Meena', 'R', 'Krishna', 'MD', 'Internal Medicine', '', '', NULL, 'O', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-10-15', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1215150479', 0, 'N', 0, '2014-01-31', NULL, NULL, 41.9147, -88.0572, NULL, NULL),
('271168572', 'W12023269', 'W12023269', 'ILCHIGSTD', 'Primary Care Services', 'Asad', '', 'Jamal', 'MD', 'Family Practice', '', '', NULL, 'O', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', '2425 W 22nd St Ste 202', 'Oak Brook', 'Dupage', 'IL', '60523', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, '', '', 'HCFA|UB|', '1013950476', 0, 'N', 0, '2013-03-25', NULL, NULL, 41.846, -87.9782, NULL, NULL),
('271168572', 'W12023270', 'W12023270', 'ILCHIGSTD', 'Primary Care Services', 'Asad', '', 'Jamal', 'MD', 'Family Practice', '', '', NULL, 'O', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', '701 N Winthrop Ave', 'Glendale Heights', 'Dupage', 'IL', '60139', '6304299000', '6304299060', 'CHIG11', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, NULL, NULL, '', '', 'HCFA|UB|', '1013950476', 0, 'N', 0, '2013-03-25', NULL, NULL, 41.9149, -88.0598, NULL, NULL),
('264333033', 'W12023284', 'W12023284', 'TXSATSTD', 'Institute for Womens Health', 'Ann', 'P', 'Miller', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1303 McCullough Ave Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '2102234555', '1303 McCullough Ste GL70', 'San Antonio', 'Bexar', 'TX', '78212', '2102269705', '2102234555', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922357748', 0, 'N', 0, '2012-11-12', NULL, NULL, 29.4407, -98.4918, NULL, NULL),
('264333033', 'W12023285', 'W12023285', 'TXSATSTD', 'Consultants in Womens Health', 'Ann', 'P', 'Miller', 'NP', 'Obstetrics and Gynecology', '', '', NULL, 'B', '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2106563040', NULL, '1210 Arion Pkwy', 'San Antonio', 'Bexar', 'TX', '78216', '2106563040', '          ', 'TXOBG', 'TXHCPCS', '', '0.00', '50.00', '0.00', 3, '2012-11-01', NULL, 0, 0, 0, 'North Central Baptist Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1922357748', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('954893928', 'W12023286', 'W12023286', 'UT01', 'Exodus Healthcare Network', 'James', 'S', 'Robbins', 'DO', 'Family Practice', '', '', NULL, 'O', '3665 S 8400 W Ste 110', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8014170063', '3665 S 8400 W Ste 110', 'Magna', 'Salt Lake', 'UT', '84044', '8012509638', '8014170063', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-04-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720234412', 0, 'N', 0, '2013-03-14', NULL, NULL, 40.6928, -112.092, NULL, NULL),
('954893928', 'W12023287', 'W12023287', 'UT01', 'Exodus Healthcare Network', 'James', 'S', 'Robbins', 'DO', 'Family Practice', '', '', NULL, 'O', '3336 S Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012509638', '8012503204', '3336 S Pioneer Pkwy Ste 201', 'Salt Lake City', 'Salt Lake', 'UT', '84120', '8012509638', '8012503204', 'WiseSTD', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2013-04-01', NULL, 0, 0, 0, 'Pioneer Valley Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1720234412', 0, 'N', 0, '2013-03-14', NULL, NULL, 40.6991, -111.99, NULL, NULL),
('870354442', 'W12023288', 'W12023288', 'UT01', 'Rocky Mountain Womens Health Center', 'Stacie', 'B', 'Carter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '3110 W 300 N Ste B', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8017760880', '8017737399', '3110 W 300 N Ste B', 'Salt Lake City', 'Salt Lake', 'UT', '84105', '8017760880', '8017737399', 'WRYMTWOM', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710180591', 0, 'N', 0, '2012-10-23', NULL, NULL, 0, 0, NULL, NULL),
('870354442', 'W12023289', 'W12023289', 'UT01', 'Rocky Mountain Womens Health Center', 'Stacie', 'B', 'Carter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'O', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', '8017737399', '1580 W Antelope Dr Ste 290', 'Layton', 'Davis', 'UT', '84041', '8017760880', '8017737399', 'WRYMTWOM', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710180591', 0, 'N', 0, '2012-10-23', NULL, NULL, 41.0893, -111.994, NULL, NULL),
('870354442', 'W12023290', 'W12023290', 'UT01', 'Rocky Mountain Womens Health Center', 'Stacie', 'B', 'Carter', 'CNM', 'Obstetrics and Gynecology', '', '', NULL, 'B', 'PO Box 844839', 'Dallas', 'Dallas', 'TX', '75284', '8017737399', '8017738625', 'PO Box 844839', 'Dallas', 'Dallas', 'TX', '75284', '8017737399', '8017738625', 'WRYMTWOM', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 3, '2012-10-01', '2014-04-30', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1710180591', 0, 'N', 0, '2012-10-23', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12023291', 'W12023291', 'UT01', 'Central Utah Clinic PC', 'John', '', 'Heflin', 'MD', 'Orthopedic Surgery', '', '', NULL, 'O', '5957 S Fashion Point Dr', 'Ogden', 'Weber', 'UT', '84403', '8014755683', '8014759499', '5957 S Fashion Point Dr', 'Ogden', 'Weber', 'UT', '84403', '8014755683', '8014759499', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-10-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1588840102', 0, 'N', 0, '2012-11-12', NULL, NULL, 41.1544, -111.937, NULL, NULL),
('870281028', 'W12023292', 'W12023292', 'UT01', 'Central Utah Clinic PC', 'John', '', 'Heflin', 'MD', 'Orthopedic Surgery', '', '', NULL, 'B', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'PO Box 30079', 'Salt Lake City', 'Salt Lake', 'UT', '84130', '8013758858', '8014298180', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-10-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1588840102', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('870281028', 'W12023293', 'W12023293', 'UT01', 'Central Utah Clinic PC', 'John', '', 'Heflin', 'MD', 'Orthopedic Surgery', '', '', NULL, 'M', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014180941', '1055 N 500 W', 'Provo', 'Utah', 'UT', '84604', '8013548225', '8014180941', 'WCUC', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-10-01', NULL, 0, 0, 0, 'Ogden Regional Medical Center', '', '', '', 'HCFA|UB|', '1588840102', 0, 'N', 0, '2012-11-12', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12023294', 'W12023294', 'UT01', 'Davis Neurology Associates', 'Gregory', 'James', 'Baker', '', 'Neurology', '', '', NULL, 'O', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', '8017737800', '1492 W Antelope Dr Ste 203', 'Layton', 'Davis', 'UT', '84041', '8017737500', '8017737800', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-09-28', '2013-04-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497775522', 0, 'N', 0, '2013-05-22', NULL, NULL, 0, 0, NULL, NULL),
('621801973', 'W12023295', 'W12023295', 'UT01', 'Physician Group of Utah, Iinc', 'Gregory', 'James', 'Baker', '', 'Neurology', '', '', NULL, 'B', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'PO Box 281415', 'Atlanta', 'Fulton', 'GA', '30384', '8019843418', '8019843479', 'WUSTDINT5', 'WUSTDHCPC5', '', '0.00', '35.00', '0.00', 6, '2012-09-28', '2013-04-19', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1497775522', 0, 'N', 0, '2013-05-22', NULL, NULL, 0, 0, NULL, NULL),
('820529971', 'W12023297', 'W12023297', 'ID02', 'Childrens Therapy Place Inc', 'Kendra ', 'R', 'Lenzi', 'OTR', 'Occupational Therapy', '', '', NULL, 'O', '6855 W Fairview Ave', 'Boise', 'Ada', 'ID', '83704', '2083238888', '2083238889', '6855 W Fairview Ave', 'Boise', 'Ada', 'ID', '83704', '2083238888', '2083238889', 'WestRehab', '', '', '0.00', '0.00', '65.00', 3, '2012-10-01', NULL, 0, 0, 1, '', '', '', '', 'HCFA|UB|', '1326335100', 0, 'N', 0, '2014-06-09', NULL, NULL, 0, 0, NULL, NULL),
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('363977608', 'W12023345', 'W12023345', 'ILCHIGSTD', 'Northwest Pediatric Services', 'Howard', '', 'Singer', 'MD', 'Pediatrics', '', '', NULL, 'O', '373 Summit St', 'Elgin', 'Kane', 'IL', '60120', '8475318430', '8475318524', '373 Summit St', 'Elgin', 'Kane', 'IL', '60120', '8475318430', '8475318524', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', '2013-06-29', 0, 0, 0, '', '', '', '', 'HCFA|UB|', '1033211826', 0, 'N', 0, '2013-09-16', NULL, NULL, 42.046, -88.2781, NULL, NULL),
('364440408', 'W12023357', 'W12023357', 'ILCHIGSTD', 'Mary Monaco MD', 'Mary', '', 'Monaco', 'MD', 'Neurology', '', '', NULL, 'O', '79 129th Infantry Dr', 'Joliet', 'Will', 'IL', '60435', '8157301541', '8157448632', '79 129th Infantry Dr', 'Joliet', 'Will', 'IL', '60435', '8157301541', '8157448632', 'CHIG2', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Presence Saint Joseph Medical Center', NULL, NULL, NULL, 'HCFA|UB|', '1972607497', 0, 'N', 0, '2013-05-31', NULL, NULL, 41.5232, -88.1506, NULL, NULL),
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('363708552', 'W12023359', 'W12023359', 'ILCHIGSTD', 'Southwest Physicians Group', '', '', 'Southwest Physicians Group', '', 'Clinics', '', '', NULL, 'B', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084254488', '7084252248', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084254488', '7084252248', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, '', '', '', '', 'HCFA|UB|', '0000009948', 0, 'Y', 0, '2012-12-05', NULL, NULL, 41.72, -87.7428, NULL, NULL),
('363708552', 'W12023361', 'W12023361', 'ILCHIGSTD', 'Southwest Physicians Group', 'Sabeeha', '', 'Haque', 'MD', 'Pediatrics', '', '', NULL, 'O', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084254488', '7084252248', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084254488', '7084252248', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Little Company of Mary Hospital', NULL, '', '', 'HCFA|UB|', '1417033705', 0, 'N', 0, '2013-03-07', NULL, NULL, 41.72, -87.7422, NULL, NULL),
('363708552', 'W12023364', 'W12023364', 'ILCHIGSTD', 'Southwest Physicians Group', 'Rama', '', 'Medavaram', 'MD', 'Family Practice', '', '', NULL, 'O', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084232880', '7084232933', '4861 W 95th St', 'Oak Lawn', 'Cook', 'IL', '60453', '7084232880', '7084232933', 'CHIG5', 'CHIHCPCS13', '', '0.00', '40.00', '0.00', 3, '2013-01-01', NULL, 0, 0, 0, 'Ingalls Memorial Hospital', NULL, NULL, NULL, 'HCFA|UB|', '1780780114', 0, 'N', 0, '2013-08-01', NULL, NULL, 41.72, -87.7422, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('111111111', 'RX0011331', 'RX0011331', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '598 COLUMBIA TPKE', 'EAST GREENBUSH', 'Rensselaer', 'NY', '12061', '5184778526', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1295838027', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011330', 'RX0011330', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1475 WESTERN AVE', 'ALBANY', 'Albany', 'NY', '12203', '5184828759', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1487757217', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011329', 'RX0011329', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1330 GERLING ST', 'SCHENECTADY', 'Schenectady', 'NY', '12308', '5183463121', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1578666301', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011328', 'RX0011328', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '625 E MAIN ST', 'LITTLE FALLS', 'Herkimer', 'NY', '13365', '3158230600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1669575494', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011327', 'RX0011327', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '39 MEADOW ST', 'CLINTON', 'Oneida', 'NY', '13323', '3158535528', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1750484580', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011326', 'RX0011326', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '944 MERRICK RD', 'BALDWIN', 'Nassau', 'NY', '11510', '5162231604', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1609970458', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011325', 'RX0011325', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '16 WEYMAN AVE', 'NEW ROCHELLE', 'Westchester', 'NY', '10805', '9142357120', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1790889541', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011324', 'RX0011324', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '503 E MAIN ST', 'PATCHOGUE', 'Suffolk', 'NY', '11772', '6317586137', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1841393675', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011323', 'RX0011323', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1070 FLATBUSH AVE', 'BROOKLYN', 'Kings', 'NY', '11226', '7182825330', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1982708731', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011322', 'RX0011322', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '301 JERUSALEM AVE', 'HEMPSTEAD', 'Nassau', 'NY', '11550', '5164858774', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1073617825', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011321', 'RX0011321', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1234 UPPER LENOX AVE', 'ONEIDA', 'Madison', 'NY', '13421', '3153611184', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1235156399', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011320', 'RX0011320', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1797 DUTCH BROADWAY', 'ELMONT', 'Nassau', 'NY', '11003', '5165611340', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1164526919', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011319', 'RX0011319', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '977 W JERICHO TPKE', 'SMITHTOWN', 'Suffolk', 'NY', '11787', '6312657143', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1255435004', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011318', 'RX0011318', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '204 GREAT EAST NECK RD', 'WEST BABYLON', 'Suffolk', 'NY', '11704', '6314227282', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1346344199', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011317', 'RX0011317', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '8302 ATLANTIC AVE', 'OZONE PARK', 'Queens', 'NY', '11416', '7182962153', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1437253283', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011316', 'RX0011316', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2535 ROUTE 9', 'MALTA', 'Saratoga', 'NY', '12020', '5188990018', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1932202769', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011315', 'RX0011315', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '101 KNOLLWOOD RD', 'WHITE PLAINS', 'Westchester', 'NY', '10607', '9146827523', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1215035928', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011314', 'RX0011314', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '355 BROADWAY # A', 'AMITYVILLE', 'Suffolk', 'NY', '11701', '6318424647', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1528162377', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011313', 'RX0011313', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '660 COLUMBUS AVE ROSE HILL S/C', 'THORNWOOD', 'Westchester', 'NY', '10594', '9147691834', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1306944012', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011312', 'RX0011312', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '583 COMMERCE DR', 'SMELTERVILLE', 'Shoshone', 'ID', '83868', '2087832739', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1740345859', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011311', 'RX0011311', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5875 E FRANKLIN RD', 'NAMPA', 'Canyon', 'ID', '83687', '2084618718', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1508950668', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011310', 'RX0011310', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '500 S UTAH AVE', 'IDAHO FALLS', 'Bonneville', 'ID', '83402', '2085288703', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1255358503', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011309', 'RX0011309', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '7319 W STATE ST', 'BOISE', 'Ada', 'ID', '83714', '2088534780', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1346267697', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011308', 'RX0011308', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3050 E MULLAN AVE', 'POST FALLS', 'Kootenai', 'ID', '83854', '2087774502', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1437176781', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011307', 'RX0011307', 'HDRX', 'FRED MEYER PHARMACY', NULL, NULL, 'FRED MEYER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5230 W FRANKLIN RD', 'BOISE', 'Ada', 'ID', '83705', '2084296433', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1376588442', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011306', 'RX0011306', 'HDRX', 'SAMS PHARMACY', NULL, NULL, 'SAMS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '700 E 17TH ST', 'IDAHO FALLS', 'Bonneville', 'ID', '83404', '2085230831', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1528085875', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011305', 'RX0011305', 'HDRX', 'FRED MEYER PHARMACY CE', NULL, NULL, 'FRED MEYER PHARMACY CE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3527 S FEDERAL WAY', 'BOISE', 'Ada', 'ID', '83705', '2084247533', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1902842594', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011304', 'RX0011304', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4051 E FAIRVIEW AVE', 'MERIDIAN', 'Ada', 'ID', '83642', '2083730024', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1619994969', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011303', 'RX0011303', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2680 S LINCOLN AVE', 'JEROME', 'Jerome', 'ID', '83338', '2083244700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1700803053', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011302', 'RX0011302', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2745 AMERICAN LEGION BLVD', 'MOUNTAIN HOME', 'Elmore', 'ID', '83647', '2085870861', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1891712147', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011301', 'RX0011301', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2100 12TH AVE RD', 'NAMPA', 'Canyon', 'ID', '83686', '2084675159', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1083631337', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011300', 'RX0011300', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5108 CLEVELAND BLVD', 'CALDWELL', 'Canyon', 'ID', '83607', '2084550800', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1174540421', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011299', 'RX0011299', 'HDRX', 'FRED MEYER PHARMACY-CI', NULL, NULL, 'FRED MEYER PHARMACY-CI', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '560 W KATHLEEN AVE', 'COEUR D ALENE', 'Kootenai', 'ID', '83815', '2086654733', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1952347866', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011298', 'RX0011298', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '8300 W OVERLAND RD', 'BOISE', 'Ada', 'ID', '83709', '2083219080', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1265459515', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011297', 'RX0011297', 'HDRX', 'FRED MEYER PHARMACY-TN', NULL, NULL, 'FRED MEYER PHARMACY-TN', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '705 BLAKE ST', 'TWIN FALLS', 'Twin Falls', 'ID', '83301', '2087365373', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1043256951', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011296', 'RX0011296', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3300 HIGHWAY 95 N', 'SANDPOINT', 'Bonner', 'ID', '83864', '2082654490', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1356368609', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011295', 'RX0011295', 'HDRX', 'FRED MEYER PHARMACY-MI', NULL, NULL, 'FRED MEYER PHARMACY-MI', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1850 E FAIRVIEW AVE', 'MERIDIAN', 'Ada', 'ID', '83642', '2088875273', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1659316180', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011294', 'RX0011294', 'HDRX', 'FRED MEYER PHARMACY-IB', NULL, NULL, 'FRED MEYER PHARMACY-IB', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '10751 W OVERLAND RD', 'BOISE', 'Ada', 'ID', '83709', '2083735233', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1134165046', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011293', 'RX0011293', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4240 YELLOWSTONE AVE', 'CHUBBUCK', 'Bannock', 'ID', '83202', '2082375091', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1447277793', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011292', 'RX0011292', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1201 S 25TH E', 'AMMON', 'Bonneville', 'ID', '83406', '2085222866', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1629095971', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011291', 'RX0011291', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '565 JENSEN GROVE DR', 'BLACKFOOT', 'Bingham', 'ID', '83221', '2087850277', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1801813159', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011290', 'RX0011290', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '530 N 2ND E', 'REXBURG', 'Madison', 'ID', '83440', '2083592814', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1992722243', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011289', 'RX0011289', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '415 RIVERVIEW DR', 'BURLEY', 'Cassia', 'ID', '83318', '2086774804', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1184641433', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011288', 'RX0011288', 'HDRX', 'SMITH''S PHARMACY', NULL, NULL, 'SMITH''S PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '937 E MAIN ST', 'BURLEY', 'Cassia', 'ID', '83318', '2086783286', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1699790212', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011287', 'RX0011287', 'HDRX', 'SMITH''S PHARMACY', NULL, NULL, 'SMITH''S PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '400 S WOODRUFF AVE', 'IDAHO FALLS', 'Bonneville', 'ID', '83401', '2085295300', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1881619401', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011286', 'RX0011286', 'HDRX', 'FRED MEYER PHARMACY-NI', NULL, NULL, 'FRED MEYER PHARMACY-NI', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '50 2ND ST S', 'NAMPA', 'Canyon', 'ID', '83651', '2084652836', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1225074131', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011285', 'RX0011285', 'HDRX', 'FRED MEYER PHARMACY-IG', NULL, NULL, 'FRED MEYER PHARMACY-IG', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5425 W CHINDEN BLVD', 'GARDEN CITY', 'Ada', 'ID', '83714', '2083237036', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1316983224', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011284', 'RX0011284', 'HDRX', 'SMITH''S PHARMACY', NULL, NULL, 'SMITH''S PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4845 YELLOWSTONE AVE', 'CHUBBUCK', 'Bannock', 'ID', '83202', '2082373900', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1972528594', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011283', 'RX0011283', 'HDRX', 'SMITH''S PHARMACY', NULL, NULL, 'SMITH''S PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1913 ADDISON AVE E', 'TWIN FALLS', 'Twin Falls', 'ID', '83301', '2087344581', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1063437689', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011282', 'RX0011282', 'HDRX', 'FRED MEYER PHARMACY-IP', NULL, NULL, 'FRED MEYER PHARMACY-IP', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1030 YELLOWSTONE AVE', 'POCATELLO', 'Bannock', 'ID', '83201', '2082328080', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1740225275', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011281', 'RX0011281', 'HDRX', 'FRED MEYER PHARMACY-II', NULL, NULL, 'FRED MEYER PHARMACY-II', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1555 NORTHGATE MILE', 'IDAHO FALLS', 'Bonneville', 'ID', '83401', '2085352553', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1831134360', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('111111111', 'RX0011280', 'RX0011280', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '95-1077 AINAMAKUA DR', 'MILILANI', 'Honolulu', 'HI', '96789', '8086262380', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1992062970', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011279', 'RX0011279', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '91-600 FARRINGTON HWY', 'KAPOLEI', 'Honolulu', 'HI', '96707', '8082069415', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1568733178', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011278', 'RX0011278', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '91-919 FORT WEAVER RD STE 106', 'EWA BEACH', 'Honolulu', 'HI', '96706', '8086895860', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1144523465', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011277', 'RX0011277', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '15-1454 KAHAKAI BLVD', 'PAHOA', 'Hawaii', 'HI', '96778', '8089653144', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1588979579', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011276', 'RX0011276', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '66-197 KAMEHAMEHA HWY STE 1', 'HALEIWA', 'Honolulu', 'HI', '96712', '8086379393', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1053622696', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011275', 'RX0011275', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1130 KUALA ST', 'PEARL CITY', 'Honolulu', 'HI', '96782', '8084565302', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1023338720', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011274', 'RX0011274', 'HDRX', 'LONGS DRUG STORE', NULL, NULL, 'LONGS DRUG STORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1748 LILIHA ST', 'HONOLULU', 'Honolulu', 'HI', '96817', '8085858472', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1902035140', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011273', 'RX0011273', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '55 KIOPAA PL', 'MAKAWAO', 'Maui', 'HI', '96768', '8085739304', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1972749414', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011272', 'RX0011272', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '966 KAHEKA ST', 'HONOLULU', 'Honolulu', 'HI', '96814', '8089457875', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1881848703', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011271', 'RX0011271', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '65-1267 KAWAIHAE RD', 'KAMUELA', 'Hawaii', 'HI', '96743', '8088854418', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1871746883', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011270', 'RX0011270', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '670 PONAHAWAI ST STE 213', 'HILO', 'Hawaii', 'HI', '96720', '8089338555', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1427218478', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011269', 'RX0011269', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '82 PUUHONU PL', 'HILO', 'Hawaii', 'HI', '96720', '8089619267', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1518127562', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011268', 'RX0011268', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '96-1115 KAMANI ST', 'PAHALA', 'Hawaii', 'HI', '96777', '8089286252', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1881856367', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011267', 'RX0011267', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '302 CALIFORNIA AVE', 'WAHIAWA', 'Honolulu', 'HI', '96786', '8086222773', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1427235654', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011266', 'RX0011266', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4469 WAIALO RD', 'ELEELE', 'Kauai', 'HI', '96705', '8083350700', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1023208253', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011265', 'RX0011265', 'HDRX', 'LONGS DRUG STORE', NULL, NULL, 'LONGS DRUG STORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '16-586 OLD VOLCANO RD', 'KEAAU', 'Hawaii', 'HI', '96749', '8089828600', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1871700914', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011264', 'RX0011264', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1900 MAIN ST STE 4', 'WAILUKU', 'Maui', 'HI', '96793', '8082449099', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1265558258', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011263', 'RX0011263', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '41 E LIPOA ST STE 23A', 'KIHEI', 'Maui', 'HI', '96753', '8088798499', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1427174358', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011262', 'RX0011262', 'HDRX', 'LONGS PHARMACY', NULL, NULL, 'LONGS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '30 AULIKE ST', 'KAILUA', 'Honolulu', 'HI', '96734', '8082663222', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1043336977', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011261', 'RX0011261', 'HDRX', 'LONGS DRUGS', NULL, NULL, 'LONGS DRUGS', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2070 N KING ST STE 5', 'HONOLULU', 'Honolulu', 'HI', '96819', '8088458324', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1790840122', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011260', 'RX0011260', 'HDRX', 'SAMS PHARMACY', NULL, NULL, 'SAMS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '750 KEEAUMOKU ST', 'HONOLULU', 'Honolulu', 'HI', '96814', '8089416719', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1275550527', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011259', 'RX0011259', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1131 KUALA ST', 'PEARL CITY', 'Honolulu', 'HI', '96782', '8084548792', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1174541650', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011258', 'RX0011258', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '700 KEEAUMOKU ST', 'HONOLULU', 'Honolulu', 'HI', '96814', '8089558611', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1366469611', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011257', 'RX0011257', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '101 PAKAULA ST', 'KAHULUI', 'Maui', 'HI', '96732', '8088717012', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1457378705', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011256', 'RX0011256', 'HDRX', 'SAMS PHARMACY', NULL, NULL, 'SAMS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1000 KAMEHAMEHA HWY STE 100', 'PEARL CITY', 'Honolulu', 'HI', '96782', '8084540182', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1548287899', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011255', 'RX0011255', 'HDRX', 'LONGS DRUG STORE', NULL, NULL, 'LONGS DRUG STORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '91-1401 FORT WEAVER RD', 'EWA BEACH', 'Honolulu', 'HI', '96706', '8086855622', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1770525503', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0011171', 'RX0011171', 'HDRX', 'SAMS PHARMACY', NULL, NULL, 'SAMS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3839 MUNDY MILL RD', 'OAKWOOD', 'Hall', 'GA', '30566', '7702877716', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1003089657', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011170', 'RX0011170', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1187 GRAYSON HWY', 'LAWRENCEVILLE', 'Gwinnett', 'GA', '30045', '7703382513', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1366617433', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011169', 'RX0011169', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2940 ANVIL BLOCK RD', 'ELLENWOOD', 'Dekalb', 'GA', '30294', '4043616811', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1023295078', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('111111111', 'RX0011168', 'RX0011168', 'HDRX', 'KROGER DRUGSTORE', NULL, NULL, 'KROGER DRUGSTORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4753 ALTANTA HIGHWAY', 'LOGANVILLE', 'Walton', 'GA', '30052', '6786394500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1467623744', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011167', 'RX0011167', 'HDRX', 'KROGER DRUGSTORE', NULL, NULL, 'KROGER DRUGSTORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '53 EXCHANGE ST', 'RICHMOND HILL', 'Bryan', 'GA', '31324', '9124593030', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1134398621', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011166', 'RX0011166', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2801 AIRPORT THRUWAY', 'COLUMBUS', 'Muscogee', 'GA', '31909', '7066534044', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1609058346', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011165', 'RX0011165', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', 'HWY 9 COMMERCE BLVD', 'ALPHARETTA', 'Fulton', 'GA', '30004', '7704754011', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1992981328', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011164', 'RX0011164', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6475 GATEWAY RD', 'COLUMBUS', 'Muscogee', 'GA', '31909', '7065636535', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1699953059', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011163', 'RX0011163', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3580 MEMORIAL DR', 'DECATUR', 'Dekalb', 'GA', '30032', '4042840707', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1538346580', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011162', 'RX0011162', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2305 JONESBORO RD', 'MCDONOUGH', 'Henry', 'GA', '30253', '7709575864', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1639355340', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011161', 'RX0011161', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2720 LOGANVILLE HWY', 'LOGANVILLE', 'Walton', 'GA', '30052', '7702775996', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1205012085', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011160', 'RX0011160', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2605 HAMILTON MILL RD', 'BUFORD', 'Gwinnett', 'GA', '30519', '6785465352', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1164605630', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011159', 'RX0011159', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1044 FURYS FERRY RD', 'EVANS', 'Columbia', 'GA', '30809', '7068603945', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1700069275', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011158', 'RX0011158', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2098 HIGHWAY 20 W', 'MCDONOUGH', 'Henry', 'GA', '30253', '7708987356', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1073796538', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011157', 'RX0011157', 'HDRX', 'KROGER DRUGSTORE', NULL, NULL, 'KROGER DRUGSTORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3094 WATSON BLVD', 'WARNER ROBINS', 'Houston', 'GA', '31093', '4789712340', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1932393550', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011156', 'RX0011156', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1455 MORELAND AVE SE', 'ATLANTA', 'Fulton', 'GA', '30316', '4046221819', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1174718373', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011155', 'RX0011155', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3095 OLD ATLANTA RD', 'CUMMING', 'Forsyth', 'GA', '30041', '7708445686', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1144415431', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011154', 'RX0011154', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '7300 GA HIGHWAY 21', 'SAVANNAH', 'Chatham', 'GA', '31407', '9129641797', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1598959132', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011153', 'RX0011153', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5815 CAMPBELLTON RD SW', 'ATLANTA', 'Fulton', 'GA', '30331', '4043464164', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1831380039', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011152', 'RX0011152', 'HDRX', 'KROGER DRUGSTORE', NULL, NULL, 'KROGER DRUGSTORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3700 SALEM RD', 'COVINGTON', 'Newton', 'GA', '30016', '6783426050', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1952592990', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011151', 'RX0011151', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5690 OGEECHEE RD', 'SAVANNAH', 'Chatham', 'GA', '31405', '9122345575', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1205034204', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011150', 'RX0011150', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3940 JONESBORO RD', 'UNION CITY', 'Fulton', 'GA', '30291', '7707741161', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1538367537', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011149', 'RX0011149', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1801 NATHAN DEAN BYP', 'ROCKMART', 'Polk', 'GA', '30153', '3787579756', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1194926642', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011148', 'RX0011148', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6381 ZEBULON RD', 'MACON', 'Bibb', 'GA', '31220', '4784761911', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1386847614', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011147', 'RX0011147', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6031 FAIRBURN RD', 'DOUGLASVILLE', 'Douglas', 'GA', '30134', '7709429214', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1740406248', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011146', 'RX0011146', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4050 WINDER HWY', 'FLOWERY BRANCH', 'Hall', 'GA', '30542', '7709651979', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1184840142', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011145', 'RX0011145', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3875 MUNDY MILL RD', 'OAKWOOD', 'Hall', 'GA', '30566', '7705353702', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1518184597', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011144', 'RX0011144', 'HDRX', 'THE KROGER COMPANY', NULL, NULL, 'THE KROGER COMPANY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1685 OLD PENDERGRASS RD', 'JEFFERSON', 'Jackson', 'GA', '30549', '7063877620', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1912028267', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011143', 'RX0011143', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1035 LOWER FAYETTEVILLE RD', 'NEWNAN', 'Coweta', 'GA', '30265', '6784238891', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1720122880', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011142', 'RX0011142', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '800 GA HIGHWAY 96', 'WARNER ROBINS', 'Houston', 'GA', '31088', '4789875055', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1023152188', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011141', 'RX0011141', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4250 ROSWELL RD', 'MARIETTA', 'Cobb', 'GA', '30062', '7705654064', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1841356300', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011140', 'RX0011140', 'HDRX', 'SAMS PHARMACY', NULL, NULL, 'SAMS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5448 WHITTLESEY BLVD STE A', 'COLUMBUS', 'Muscogee', 'GA', '31909', '7066496322', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1194880153', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011139', 'RX0011139', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1871 CHAMBLEE TUCKER RD', 'ATLANTA', 'Dekalb', 'GA', '30341', '7704554699', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1659436863', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011138', 'RX0011138', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6149 OLD NATIONAL HWY', 'ATLANTA', 'Fulton', 'GA', '30349', '7709940199', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1922163138', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011137', 'RX0011137', 'HDRX', 'KROGER DRUGSTORE', NULL, NULL, 'KROGER DRUGSTORE', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1751 NEWNAN CROSSING BLVD E', 'NEWNAN', 'Coweta', 'GA', '30265', '6784235845', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1710040225', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0011136', 'RX0011136', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4825 BATTLEFIELD PKWY', 'RINGGOLD', 'Catoosa', 'GA', '30736', '7068669278', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1184836033', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0011134', 'RX0011134', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3826 COBB PKWY NW', 'ACWORTH', 'Cobb', 'GA', '30101', '7709661366', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1578653549', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
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('111111111', 'RX0010968', 'RX0010968', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6625 HIGHWAY 53 E', 'DAWSONVILLE', 'Dawson', 'GA', '30534', '7062165500', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1265466007', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010967', 'RX0010967', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1172 MILFORD CHURCH RD SW', 'MARIETTA', 'Cobb', 'GA', '30060', '7703192540', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1730283664', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010966', 'RX0010966', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1029 FOREST PKWY', 'FOREST PARK', 'Clayton', 'GA', '30297', '4046080751', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1821192758', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010965', 'RX0010965', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '11710 ALPHARETTA HWY', 'ROSWELL', 'Fulton', 'GA', '30076', '7707540141', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1912001843', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010964', 'RX0010964', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '7055 OLD NATIONAL HWY', 'RIVERDALE', 'Clayton', 'GA', '30296', '7709095672', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1609970532', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010958', 'RX0010958', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2738 N DECATUR RD', 'DECATUR', 'Dekalb', 'GA', '30033', '4045088058', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1528162450', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010957', 'RX0010957', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1943 PEACHTREE RD NE', 'ATLANTA', 'Fulton', 'GA', '30309', '4043514932', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1700980638', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010955', 'RX0010955', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3513 BAKER RD NW STE 500', 'ACWORTH', 'Cobb', 'GA', '30101', '7709170408', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1730282500', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010953', 'RX0010953', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2295 TOWNE LAKE PKWY', 'WOODSTOCK', 'Cherokee', 'GA', '30189', '7705172088', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1720012560', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010952', 'RX0010952', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4432 MILLER RD', 'COLUMBUS', 'Muscogee', 'GA', '31909', '7065615001', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1780787242', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010951', 'RX0010951', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '12070 CRABAPPLE RD', 'ROSWELL', 'Fulton', 'GA', '30075', '7709925446', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1982708806', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010950', 'RX0010950', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3544 CANTON RD', 'MARIETTA', 'Cobb', 'GA', '30066', '7709265669', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1164526083', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010949', 'RX0010949', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4595 HIGHWAY 92', 'ACWORTH', 'Cherokee', 'GA', '30102', '7705169946', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1346344264', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010948', 'RX0010948', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '270 WALMART WAY', 'DAHLONEGA', 'Lumpkin', 'GA', '30533', '7068676918', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1093732323', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010947', 'RX0010947', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '7207 ROCKBRIDGE RD', 'STONE MOUNTAIN', 'Dekalb', 'GA', '30087', '7704692002', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1528162443', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010946', 'RX0010946', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1190 INDIAN TRAIL LILBURN RD', 'NORCROSS', 'Gwinnett', 'GA', '30093', '7706388958', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1821191693', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('111111111', 'RX0010945', 'RX0010945', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3435 WRIGHTSBORO RD', 'AUGUSTA', 'Richmond', 'GA', '30909', '7067337352', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1245255926', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010944', 'RX0010944', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1101 N PEACHTREE PKWY', 'PEACHTREE CITY', 'Fayette', 'GA', '30269', '7704867211', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1336164011', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010943', 'RX0010943', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '5665 ATLANTA HWY', 'ALPHARETTA', 'Fulton', 'GA', '30004', '7707525388', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1811921653', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010942', 'RX0010942', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4183 HIGHWAY 278 NE', 'COVINGTON', 'Newton', 'GA', '30014', '7703855282', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1912000787', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010941', 'RX0010941', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2100 ROSWELL RD', 'MARIETTA', 'Cobb', 'GA', '30062', '7703211088', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1427073105', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010940', 'RX0010940', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1606 MEMORIAL DR', 'WAYCROSS', 'Ware', 'GA', '31501', '9122872277', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1902830748', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010848', 'RX0010848', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4700 JONESBORO RD', 'UNION CITY', 'Fulton', 'GA', '30291', '7709646036', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1548288012', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010846', 'RX0010846', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1500 MARKET PLACE BLVD', 'CUMMING', 'Forsyth', 'GA', '30041', '7708879709', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1568489896', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010842', 'RX0010842', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6000 OGEECHEE RD', 'SAVANNAH', 'Chatham', 'GA', '31419', '9129276117', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1740207075', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010838', 'RX0010838', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '150 ALTAMA CONNECTOR', 'BRUNSWICK', 'Glynn', 'GA', '31525', '9122610553', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1922025253', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010837', 'RX0010837', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '800 BLAKELY ST', 'CUTHBERT', 'Randolph', 'GA', '39840', '2297322191', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1609979459', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010836', 'RX0010836', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '13427 HIGHWAY 27', 'TRION', 'Chattooga', 'GA', '30753', '7067342840', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1013934348', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL);
INSERT INTO `providers_new` (`Provider_Tax_ID`, `Provider_Suffix`, `Provider_Network_ID`, `Provider_Region`, `Provider_Name`, `Provider_Doctor_First_Name`, `Provider_Doctor_Middle_Name`, `Provider_Doctor_Last_Name`, `Provider_Doctor_Degree`, `Provider_Specialty_1`, `Provider_Specialty_2`, `Provider_Specialty_3`, `Provider_Specialty_4`, `Provider_Address_Type`, `Provider_Address`, `Provider_City`, `Provider_County`, `Provider_State`, `Provider_Zip`, `Provider_Phone`, `Provider_Fax`, `Provider_Mailing_Address`, `Provider_Mailing_City`, `Provider_Mailing_County`, `Provider_Mailing_State`, `Provider_Mailing_Zip`, `Provider_Mailing_Phone`, `Provider_Mailing_Fax`, `Provider_Primary_Schedule`, `Provider_Secondary_Schedule`, `Provider_Rate_Sheet`, `Provider_Anes_Rate`, `Provider_Default_Rate`, `Provider_Max_DOS`, `Provider_Min_Match_Value`, `Provider_Effective_Date`, `Provider_Term_Date`, `Provider_Pend`, `Provider_Anes_Minutes`, `Provider_PPO`, `Provider_Hospital_1`, `Provider_Hospital_2`, `Provider_Hospital_3`, `Provider_Hospital_4`, `Provider_Type`, `Provider_NPI`, `Provider_Check_Override`, `Exclude_Dir`, `Audit_Status`, `Last_Change_Date`, `Medicare_ID`, `Provider_Lang`, `Provider_Latitude`, `Provider_Longitude`, `Provider_school`, `Provider_cert`) VALUES
('111111111', 'RX0010835', 'RX0010835', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '700 BIG A RD S', 'TOCCOA', 'Stephens', 'GA', '30577', '7062821193', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1720006299', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010834', 'RX0010834', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '7055 HIGHWAY 85', 'RIVERDALE', 'Clayton', 'GA', '30274', '7709940657', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1104843432', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010833', 'RX0010833', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '802W E SPRING ST', 'MONROE', 'Walton', 'GA', '30655', '7702674175', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1295752525', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010832', 'RX0010832', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3100 JOHNSON FERRY RD', 'MARIETTA', 'Cobb', 'GA', '30062', '7706428466', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1649297961', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010831', 'RX0010831', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6586 GA HIGHWAY 40 E', 'SAINT MARYS', 'Camden', 'GA', '31558', '9125109221', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1730106055', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010830', 'RX0010830', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '179 W ATHENS ST', 'WINDER', 'Barrow', 'GA', '30680', '7703071272', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1821015140', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010829', 'RX0010829', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2135 MAIN ST E', 'SNELLVILLE', 'Gwinnett', 'GA', '30078', '7709791911', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1912924234', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010828', 'RX0010828', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '107 SPRING ST', 'TALLAPOOSA', 'Haralson', 'GA', '30176', '7705742914', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1790888543', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010827', 'RX0010827', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3618 HIGHWAY 138 SE', 'STOCKBRIDGE', 'Henry', 'GA', '30281', '7704745309', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1356375182', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010826', 'RX0010826', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '14010 ABERCORN ST', 'SAVANNAH', 'Chatham', 'GA', '31419', '9129250396', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1447284278', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010825', 'RX0010825', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '730 NORTHSIDE DR E', 'STATESBORO', 'Bulloch', 'GA', '30458', '9127642110', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1003833328', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010824', 'RX0010824', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '955 ELBERT EXT #', 'ELBERTON', 'Elbert', 'GA', '30635', '7062838735', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1194742411', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010823', 'RX0010823', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '2101 VETERANS BLVD', 'DUBLIN', 'Laurens', 'GA', '31021', '4782728060', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1386661601', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010822', 'RX0010822', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '4110 PLEASANT HILL RD', 'DULUTH', 'Gwinnett', 'GA', '30096', '7704180510', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1982707733', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
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('111111111', 'RX0010736', 'RX0010736', 'HDRX', 'KROGER PHARMACY', NULL, NULL, 'KROGER PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '3128 DEANS BRIDGE RD', 'AUGUSTA', 'Richmond', 'GA', '30906', '7067900761', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1851325682', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010735', 'RX0010735', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6020 HARRISON RD', 'MACON', 'Bibb', 'GA', '31206', '4787888008', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1477570885', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010734', 'RX0010734', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1572 ANDERSON HWY', 'HARTWELL', 'Hart', 'GA', '30643', '7063765197', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1568489979', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010733', 'RX0010733', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '31 MAYS CROSSING S/C', 'STOCKBRIDGE', 'Henry', 'GA', '30281', '7703894905', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1659398063', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010732', 'RX0010732', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1301 A S PARK', 'CARROLLTON', 'Carroll', 'GA', '30117', '7708341010', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1831116243', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010731', 'RX0010731', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '125 PAVILION PKWY', 'FAYETTEVILLE', 'Fayette', 'GA', '30214', '7704600726', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1922025337', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010730', 'RX0010730', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1450 BOWENS MILL RD SE', 'DOUGLAS', 'Coffee', 'GA', '31533', '9123845492', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1013934421', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010729', 'RX0010729', 'HDRX', 'CVS PHARMACY', NULL, NULL, 'CVS PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '308 SOUTH US HIGHWAY 441', 'CLAYTON', 'Rabun', 'GA', '30525', '7067822722', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1609979434', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010728', 'RX0010728', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '818 S TALLAHASSEE ST', 'HAZLEHURST', 'Jeff Davis', 'GA', '31539', '9123753646', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1104843515', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010727', 'RX0010727', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '6065 JONESBORO RD', 'MORROW', 'Clayton', 'GA', '30260', '7709680660', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1295752608', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010726', 'RX0010726', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '1029 HIGHWAY 19 N', 'THOMASTON', 'Upson', 'GA', '30286', '7066482109', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1487671897', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL),
('111111111', 'RX0010725', 'RX0010725', 'HDRX', 'WAL-MART PHARMACY', NULL, NULL, 'WAL-MART PHARMACY', NULL, 'Pharmacy', NULL, NULL, NULL, 'O', '201 VIRGINIA AVE N', 'TIFTON', 'Tift', 'GA', '31794', '2293860374', NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, NULL, '0.00', '100.00', NULL, 3, '2012-01-01', NULL, 0, 0, 0, NULL, NULL, NULL, NULL, 'HCFA|', '1578580981', 0, 'N', 0, '2012-10-02', NULL, NULL, 0, 0, NULL, NULL);
