| NAME |
CROWNPOINT CL,IN (EFF. 1/1/97) |
| STATE |
INDIANA |
| STREET ADDR. 1 |
9301 MADISON ST |
| CITY |
CROWNPOINT |
| ZIP |
46307-7745 |
| OFFICIAL VA NAME |
ADAM BENJAMIN JR OPC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CROWN POINT IN VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1952354672
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
537BY |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1952354672
-
- CODING SYSTEM: VASTANUM
- ID: 537BY
-
- CODING SYSTEM: CLIA
- ID: 15D0988053
|
