GLENDIVE VA CLINIC (1045)    INSTITUTION (4)

Name Value
NAME GLENDIVE VA CLINIC
STATE MONTANA
STREET ADDR. 1 2000 MONTANA AVENUE
CITY GLENDIVE
ZIP 59330-3700
OFFICIAL VA NAME GLENDIVE VA CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME GLENDIVE VA CLINIC
ST. ADDR. 1 (MAILING) 2000 MONTANA AVENUE
CITY (MAILING) GLENDIVE
STATE (MAILING) MONTANA
ZIP (MAILING) 59330-3700
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1386682433
TAXONOMY CODE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 436GK
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1386682433
  • CODING SYSTEM:   VASTANUM
    ID:   436GK
  • CODING SYSTEM:   CLIA
    ID:   27D1107420