| NAME |
CLOVIS |
| STATE |
NEW MEXICO |
| STREET ADDR. 1 |
921 EAST LLANO ESTACADO BLVD |
| CITY |
CLOVIS |
| ZIP |
88101-3807 |
| OFFICIAL VA NAME |
CLOVIS OUTPATIENT CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CLOVIS VA CBOC |
| ST. ADDR. 1 (MAILING) |
921 EAST LLANO ESTACADO BLVD |
| CITY (MAILING) |
CLOVIS |
| STATE (MAILING) |
NEW MEXICO |
| ZIP (MAILING) |
88101-3807 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1821040957
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
504BZ |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1821040957
-
- CODING SYSTEM: VASTANUM
- ID: 504BZ
-
- CODING SYSTEM: CLIA
- ID: 32D0987890
|
