| NAME |
STATE COLLEGE VA CLINIC |
| STATE |
PENNSYLVANIA |
| STREET ADDR. 1 |
2581 CLYDE AVE |
| CITY |
STATE COLLEGE |
| ZIP |
16801-9998 |
| OFFICIAL VA NAME |
STATE COLLEGE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
STATE COLLEGE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1134168032
-
- 2015-03-03 00:00:00
- STATUS: ACTIVE
- NPI: 1134168032
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
503GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1134168032
-
- CODING SYSTEM: VASTANUM
- ID: 503GC
-
- CODING SYSTEM: CLIA
- ID: 39D1002304
|