Tracking Details - #1187

Tracking Information
Case No: 1104
Order Date: 11/15/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: Smithtown Center for Rehabilitation & Nursing Care
391 North Country Road
Smithtown, NY 11787
Phone: (631) 361-2020 • Fax: 631-361-3305
Patient: Taylor Swift
DOB: 12/25/2000 • SSN: ***-**-8420
Smithtown Center for Rehabilitation & Nursing Care
391 North Country Road
Smithtown, NY 11787
Phone: (631) 361-2020 • Fax: 631-361-3305
Taylor Swift
DOB: 12/25/2000 • SSN: ***-**-8420
Requested Records
Record Status
Billing Pending
Films Pending
Medical Pending
File Name Uploaded Date Uploaded By
Juan Ochoa - Medical and Hospital Authorizations - Seguro v Seguro_20251115025608028.pdf 2025-11-15
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 11/14/2025 9:56 PM
Generation Dept - Printed Packet 11/18/2025 Yes 11/18/2025 3:02 AM
Order Closed Yes 11/26/2025 5:35 PM
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