| NAME |
CAMBRIDGE VA CLINIC (512GA) |
| STATE |
MARYLAND |
| STREET ADDR. 1 |
830 CHESAPEAKE DR |
| CITY |
CAMBRIDGE |
| ZIP |
21613-9408 |
| OFFICIAL VA NAME |
CAMBRIDGE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CAMBRIDGE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
830 CHESAPEAKE DR |
| CITY (MAILING) |
CAMBRIDGE |
| STATE (MAILING) |
MARYLAND |
| ZIP (MAILING) |
21613-9408 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1073564688
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
512GA |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1073564688
-
- CODING SYSTEM: VASTANUM
- ID: 512GA
|
