| NAME |
ZZ-ELIZABETH, NJ CBOC |
| STATE |
NEW JERSEY |
| STREET ADDR. 1 |
654 EAST JERSEY STREET |
| CITY |
ELIZABETH |
| ZIP |
07201-1261 |
| OFFICIAL VA NAME |
ELIZABETH CBOC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ELIZABETH VA CLINIC |
| ST. ADDR. 1 (MAILING) |
654 EAST JERSEY STREET |
| CITY (MAILING) |
ELIZABETH |
| STATE (MAILING) |
NEW JERSEY |
| ZIP (MAILING) |
07201-1261 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1093768038
-
- 2022-01-13 00:00:00
- STATUS: INACTIVE
- NPI: 1093768038
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
561GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1093768038
-
- CODING SYSTEM: VASTANUM
- ID: 561GB
|
