CHARLESTON VA CLINIC (581GB) (1454)    INSTITUTION (4)

Name Value
NAME CHARLESTON VA CLINIC (581GB)
STATE WEST VIRGINIA
STREET ADDR. 1 700 TECHNOLOGY DRIVE
CITY SOUTH CHARLESTON
ZIP 25309-8571
OFFICIAL VA NAME CHARLESTON VA CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SOUTH CHARLESTON VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1144271883
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 581GB
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1144271883
  • CODING SYSTEM:   VASTANUM
    ID:   581GB
  • CODING SYSTEM:   CLIA
    ID:   51D1012948