GREAT FALLS CBOC (1039)    INSTITUTION (4)

Name Value
NAME GREAT FALLS CBOC
STATE MONTANA
STREET ADDR. 1 1400 29th ST SOUTH, STE 1
CITY GREAT FALLS
ZIP 59405-5315
OFFICIAL VA NAME GREAT FALLS CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME GREAT FALLS VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1518912120
TAXONOMY CODE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 436GB
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1518912120
  • CODING SYSTEM:   VASTANUM
    ID:   436GB
  • CODING SYSTEM:   CLIA
    ID:   27D1002264