| NAME |
ROME CBOC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
125 BROOKLEY ROAD |
| STREET ADDR. 2 |
BUILDING 510 |
| CITY |
ROME |
| ZIP |
13441-4301 |
| OFFICIAL VA NAME |
ROME CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ROME VA CLINIC |
| ST. ADDR. 1 (MAILING) |
125 BROOKLEY ROAD |
| ST. ADDR. 2 (MAILING) |
BUILDING 510 |
| CITY (MAILING) |
ROME |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
13441-4301 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1366480360
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528GM |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1366480360
-
- CODING SYSTEM: VASTANUM
- ID: 528GM
-
- CODING SYSTEM: CLIA
- ID: 33D1038010
|
