BANGOR MAINE CBOC (1024)    INSTITUTION (4)

Name Value
NAME BANGOR MAINE CBOC
STATE MAINE
STREET ADDR. 1 35 STATE HOSPITAL DRIVE
CITY BANGOR
ZIP 04401-8816
OFFICIAL VA NAME BANGOR MAINE CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME BANGOR VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1033160064
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 402HB
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1033160064
  • CODING SYSTEM:   VASTANUM
    ID:   402HB