| NAME |
BRAXTON COUNTY VA CLINIC |
| STATE |
WEST VIRGINIA |
| STREET ADDR. 1 |
40 RESTON PLACE |
| CITY |
GASSAWAY |
| ZIP |
26624-7899 |
| OFFICIAL VA NAME |
BRAXTON COUNTY VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GASSAWAY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1790739118
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
540GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1790739118
-
- CODING SYSTEM: VASTANUM
- ID: 540GC
-
- CODING SYSTEM: CLIA
- ID: 51D2005843
|
