| NAME |
CLARKSBURG/WOOD |
| STATE |
WEST VIRGINIA |
| STREET ADDR. 1 |
2311 OHIO AVENUE, SUITE A |
| CITY |
PARKERSBURG |
| ZIP |
26101-2559 |
| OFFICIAL VA NAME |
CLARKSBURG/WOOD |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PARKERSBURG VA CBOC |
| ST. ADDR. 1 (MAILING) |
2311 OHIO AVENUE, SUITE A |
| CITY (MAILING) |
PARKERSBURG |
| STATE (MAILING) |
WEST VIRGINIA |
| ZIP (MAILING) |
26101-2559 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1508804964
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
540GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1508804964
-
- CODING SYSTEM: VASTANUM
- ID: 540GB
-
- CODING SYSTEM: CLIA
- ID: 51D1107644
|
