H;C01368;C01368;;20250715;TA113823-Grider;;;;;Newman Community Rx;1400 W12th Ave;;Emporia;KS;66801;;;Grider;003
D;BCO3;;PR;1;Diane Grider;
D;80021XW090;;PR;1;Diane Grider;
D;COMP;;PR;No;;
H;C03535;C03535;;20250715;TA113825-7/15/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;7/15/25;003
D;980XW085;;PR;1;Karen Bowling;
D;COMP;;PR;No;;
H;C00168;C00168;;20250715;TA113827;;;;;Alliance Prosthetics and Orthotics;12458 Washington Blvd;;Whittier;CA;90602;;;;003
D;TCO3;;PR;1;Angela Guarine;
D;COMP;;PR;No;;
H;C03535;C03535;;20250715;TA113828-7/15/25;;;;;Faculty Physicians;1415 Old Weisgarber Road suite 350;;Knoxville;TN;37909;;;7/15/25;003
D;FOP;;PR;1;Ky Upton;
D;COMP;;PR;No;;
H;C03655;C03655;;20250715;TA113829-07152025GR;;;;;PA Artificial Limb & Brace;224 West 26th Street;;Erie;PA;16508;;;07152025GR;003
D;FOP;;PR;1;WILLIAM WALKER;
D;40032M120;;PR;1;WILLIAM WALKER;
D;COMP;;PR;No;;
H;C04466;C04466;;20250715;TA113830;;;;;The Medicine Shoppe;1000 Market Street;;Bloomsburg;PA;17815;;;;003
D;TCO3;;PR;1;Ronald Lenker;
D;20021XW085;;PR;1;Ronald Lenker;
D;COMP;;PR;No;;
H;C00168;C00168;;20250715;TA113831;;;;;Alliance Prosthetics and Orthotics;12458 Washington Blvd;;Whittier;CA;90602;;;;003
D;TCO3;;PR;1;Efrain Barba;
D;COMP;;PR;No;;