Tracking Details - #1212

Tracking Information
Case No: 1112
Order Date: 12/05/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: Planned Parenthood - Smithtown Health Center
70 Maple Avenue
Smithtown, NY 11787
Phone: (631) 361-7526 • Fax: 631-361-7678
Patient: Oprah Winfrey
DOB: 12/16/1989 • SSN: ***-**-7667
Planned Parenthood - Smithtown Health Center
70 Maple Avenue
Smithtown, NY 11787
Phone: (631) 361-7526 • Fax: 631-361-7678
Oprah Winfrey
DOB: 12/16/1989 • SSN: ***-**-7667
Requested Records
Record Status
Billing Pending
File Name Uploaded Date Uploaded By
NextDocument_20251205032126986.pdf 2025-12-05
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 12/4/2025 10:21 PM
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