| NAME |
BURLINGTON LAKESIDE CBOC |
| STATE |
VERMONT |
| STREET ADDR. 1 |
128 LAKESIDE AVE #260 |
| CITY |
BURLINGTON |
| ZIP |
05401-5911 |
| OFFICIAL VA NAME |
BURLINGTON LAKESIDE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
BURLINGTON VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1184675795
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
405HA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1184675795
-
- CODING SYSTEM: VASTANUM
- ID: 405HA
-
- CODING SYSTEM: CLIA
- ID: 47D0991215
|
