| NAME |
OSWEGO CBOC |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
293 STATE ROUTE 104 STE 70 |
| CITY |
OSWEGO |
| ZIP |
13126-2946 |
| OFFICIAL VA NAME |
OSWEGO CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
OSWEGO VA CLINIC |
| ST. ADDR. 1 (MAILING) |
293 STATE ROUTE 104 STE 70 |
| CITY (MAILING) |
OSWEGO |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
13126-2946 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1104864743
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
528GP |
| HISTORY |
-
-
- STREET ADDR. 1 (CHANGED FROM): 437 STATE ROUTE 104E
- CITY (CHANGED FROM): OSWEGO
- STATE (CHANGED FROM): NEW YORK
- ZIP (CHANGED FROM): 13126-2998
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1104864743
-
- CODING SYSTEM: VASTANUM
- ID: 528GP
-
- CODING SYSTEM: CLIA
- ID: 33D2015733
|
