BENNINGTON CBOC (1027)    INSTITUTION (4)

Name Value
NAME BENNINGTON CBOC
STATE VERMONT
STREET ADDR. 1 186 NORTH ST
CITY BENNINGTON
ZIP 05201-1874
OFFICIAL VA NAME BENNINGTON VERMONT OUTREACH CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME BENNINGTON VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1801847447
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 405GA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1801847447
  • CODING SYSTEM:   VASTANUM
    ID:   405GA