Health System/Healthcare Organization,Facility Name,Facility NPI,Facility Root OID Xpath: /ClinicalDocument/custodian/assignedCustodian/representedCustodianOrganization/id/@root,Facility Extension Xpath: /ClinicalDocument/custodian/assignedCustodian/representedCustodianOrganization/id/@extension,Facility CLIA # (if applicable),Facility Physical Street Address,Facility City,Facility State,Facility ZIP,Facility Type (hospital; clinic; ambulatory; LTC; surgery; urgent care; other: please specify)
Example: ABC HEALTH,ABC HEALTH RALEIGH DOWNTOWN,1234567,2.16.123.1.112345.3.4,7654321,54321,919.555.5555,RALEIGH,NC,27612,HOSPITAL