| NAME |
WELLSVILLE |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
3458 RIVERSIDE DRIVE, ROUTE 19 |
| CITY |
WELLSVILLE |
| ZIP |
14895-9581 |
| OFFICIAL VA NAME |
WELLSVILLE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WELLSVILLE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
3458 RIVERSIDE DRIVE, ROUTE 19 |
| CITY (MAILING) |
WELLSVILLE |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
14895-9581 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1487694253
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528G8 |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1487694253
-
- CODING SYSTEM: VASTANUM
- ID: 528G8
-
- CODING SYSTEM: CLIA
- ID: 33D1076901
|
