| NAME |
WATERTOWN CBOC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
1222 ARSENAL ST STE 10A |
| CITY |
WATERTOWN |
| ZIP |
13601-2223 |
| OFFICIAL VA NAME |
WATERTOWN CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WATERTOWN VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-03-26 00:00:00
- STATUS: ACTIVE
- NPI: 1942357033
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528GO |
| HISTORY |
-
-
- STREET ADDR. 1 (CHANGED FROM): 144 EASTERN BLVD
- STREET ADDR. 2 (CHANGED FROM): C.A.N.I. BUILDING
- CITY (CHANGED FROM): WATERTOWN
- STATE (CHANGED FROM): NEW YORK
- ZIP (CHANGED FROM): 13601-3132
|
| IDENTIFIER |
-
- CODING SYSTEM: VASTANUM
- ID: 528GO
|
