| NAME |
LAKE COUNTY VA CLINIC |
| STATE |
OHIO |
| STREET ADDR. 1 |
35000 KAISER COURT |
| CITY |
WILLOUGHBY |
| ZIP |
44094-3382 |
| OFFICIAL VA NAME |
PAINSVILLE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WILLOUGHBY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1902844558
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
541GF |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1902844558
-
- CODING SYSTEM: VASTANUM
- ID: 541GF
-
- CODING SYSTEM: CLIA
- ID: 36D1011861
|
