| NAME |
JACKSONVILLE VA CLINIC |
| STATE |
NORTH CAROLINA |
| STREET ADDR. 1 |
4006 HENDERSON DRIVE |
| CITY |
JACKSONVILLE |
| ZIP |
28546-9998 |
| OFFICIAL VA NAME |
JACKSONVILLE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
JACKSONVILLE 1 VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1568417798
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
565GA |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1568417798
-
- CODING SYSTEM: VASTANUM
- ID: 565GA
-
- CODING SYSTEM: CLIA
- ID: 34D1017014
|
