| NAME |
GLEN BURNIE VA CLINIC |
| STATE |
MARYLAND |
| STREET ADDR. 1 |
808 LANDMARK DR #128 |
| CITY |
GLEN BURNIE |
| ZIP |
21061-4983 |
| OFFICIAL VA NAME |
GLEN BURNIE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GLEN BURNIE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1972557304
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
512GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1972557304
-
- CODING SYSTEM: VASTANUM
- ID: 512GC
-
- CODING SYSTEM: CLIA
- ID: 21D0987070
|
