H;C04466;C04466;;20250528;TA110912;;;;;The Medicine Shoppe;1000 Market Street;;Bloomsburg;PA;17815;;;;003
D;TCO3;;PR;1;Shirley Kramer;
D;792XW065;;PR;1;Shirley Kramer;
D;COMP;;PR;No;;
H;C03535;C03535;;20250528;TA110915-5/28/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;5/28/25;003
D;FOP;;PR;1;Garrett Gibson;
D;COMP;;PR;No;;