ESPANOLA VA CLINIC (1114) INSTITUTION (4)

Name	Value
NAME	ESPANOLA VA CLINIC
STATE	NEW MEXICO
STREET ADDR. 1	105 S CORONADO AVE
CITY	ESPANOLA
ZIP	87532-2862
OFFICIAL VA NAME	ESPANOLA VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 22 PARENT FACILITY PARENT OF ASSOCIATION: RAYMOND G. MURPHY VAMC
BILLING FACILITY NAME	ESPANOLA VA CLINIC
EFFECTIVE DATE/TIME	2007-01-08 00:00:00 STATUS: ACTIVE NPI: 1972556322
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	MOUNTAIN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	501GE
IDENTIFIER	CODING SYSTEM: NPI ID: 1972556322 CODING SYSTEM: VASTANUM ID: 501GE