SANDUSKY CBOC (1291)    INSTITUTION (4)

Name Value
NAME SANDUSKY CBOC
STATE OHIO
STREET ADDR. 1 1912 HAYES AVENUE
CITY SANDUSKY
ZIP 44870-4736
OFFICIAL VA NAME SANDUSKY CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SANDUSKY VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1124066105
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 541GC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1124066105
  • CODING SYSTEM:   VASTANUM
    ID:   541GC
  • CODING SYSTEM:   CLIA
    ID:   36D1011855