MACON CBOC (1382)    INSTITUTION (4)

Name Value
NAME MACON CBOC
STATE GEORGIA
STREET ADDR. 1 5566 THOMASTON RD
CITY MACON
ZIP 31220-8118
OFFICIAL VA NAME MACON VA CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MACON VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1023065638
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 557GA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1023065638
  • CODING SYSTEM:   VASTANUM
    ID:   557GA
  • CODING SYSTEM:   CLIA
    ID:   11D0648134