| NAME |
SUMTER CBOC |
| STATE |
SOUTH CAROLINA |
| STREET ADDR. 1 |
245 N BULTMAN DR |
| CITY |
SUMTER |
| ZIP |
29150-9998 |
| OFFICIAL VA NAME |
SUMTER CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SUMTER VA CLINIC |
| ST. ADDR. 1 (MAILING) |
245 N BULTMAN DR |
| CITY (MAILING) |
SUMTER |
| STATE (MAILING) |
SOUTH CAROLINA |
| ZIP (MAILING) |
29150-9998 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1972542983
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
544GF |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 407 N SALEM AVE
- CITY (CHANGED FROM): SUMTER
- STATE (CHANGED FROM): SOUTH CAROLINA
- ZIP (CHANGED FROM): 29150-4115
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1972542983
-
- CODING SYSTEM: VASTANUM
- ID: 544GF
-
- CODING SYSTEM: CLIA
- ID: 42D1045963
|
