| NAME |
BLOOMINGTON VA CLINIC |
| STATE |
INDIANA |
| STREET ADDR. 1 |
2100 SOUTH LIBERTY DR |
| CITY |
BLOOMINGTON |
| ZIP |
47403-5147 |
| OFFICIAL VA NAME |
BLOOMINGTON VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
BLOOMINGTON VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1831140417
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
583GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1831140417
-
- CODING SYSTEM: VASTANUM
- ID: 583GB
-
- CODING SYSTEM: CLIA
- ID: 15D1020721
|
