| NAME |
EK OUTPATIENT CLINIC |
| STATE |
KENTUCKY |
| STREET ADDR. 1 |
5230 KENTUCKY RT 321, SUITE 8 |
| CITY |
PRESTONSBURG |
| ZIP |
41653-9169 |
| OFFICIAL VA NAME |
PRESTONSBURG CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PRESTONBURG VA CBOC |
| ST. ADDR. 1 (MAILING) |
5230 KENTUCKY RT 321, SUITE 8 |
| CITY (MAILING) |
PRESTONSBURG |
| STATE (MAILING) |
KENTUCKY |
| ZIP (MAILING) |
41653-9169 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1366480436
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
581GA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1366480436
-
- CODING SYSTEM: VASTANUM
- ID: 581GA
-
- CODING SYSTEM: CLIA
- ID: 18D1012949
|
