CHEYENNE VA MEDICAL (141)    INSTITUTION (4)

Name Value
NAME CHEYENNE VA MEDICAL
STATE WYOMING
STREET ADDR. 1 2360 E PERSHING BLVD
CITY CHEYENNE
ZIP 82001-5356
OFFICIAL VA NAME CHEYENNE VA MEDICAL
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME CHEYENNE VAMC
ST. ADDR. 1 (MAILING) 2360 E PERSHING BLVD
CITY (MAILING) CHEYENNE
STATE (MAILING) WYOMING
ZIP (MAILING) 82001-5356
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1164471991
TAXONOMY CODE
  • Hospitals
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 442
HISTORY
  • STREET ADDR. 1 (CHANGED FROM):   2360 E PERSHING BLVD
    STREET ADDR. 2 (CHANGED FROM):   2360 East Pershing Boulevard
    CITY (CHANGED FROM):   CHEYENNE
    STATE (CHANGED FROM):   WYOMING
    ZIP (CHANGED FROM):   82001-5356
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1164471991
  • CODING SYSTEM:   VASTANUM
    ID:   442
  • CODING SYSTEM:   CLIA
    ID:   53D0987838