| NAME |
FITCHBURG CBOC |
| STATE |
MASSACHUSETTS |
| STREET ADDR. 1 |
881 MAIN STREET |
| CITY |
FITCHBURG |
| ZIP |
01420-3057 |
| OFFICIAL VA NAME |
FITCHBURG CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FITCHBURG VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: INACTIVE
- NPI: 1629021506
-
- 2011-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1659665537
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
631GF |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 881 MAIN STREET
- CITY (CHANGED FROM): FITCHBURG
- STATE (CHANGED FROM): MASSACHUSETTS
- ZIP (CHANGED FROM): 01420-3057
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1629021506
-
- CODING SYSTEM: VASTANUM
- ID: 518GG
|
