| NAME |
SAULT SAINT MARIE CBOC |
| STATE |
MICHIGAN |
| STREET ADDR. 1 |
3440 I 75 BUSINESS SPUR |
| CITY |
SAULT STE MARIE |
| ZIP |
49783-3607 |
| OFFICIAL VA NAME |
SAULT SAINT MARIE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SAULT SAINTE MARIE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1588602254
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
585HB |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 509 OSBORN BLVD SUITE 306
- CITY (CHANGED FROM): SAULT STE MARIE
- STATE (CHANGED FROM): MICHIGAN
- ZIP (CHANGED FROM): 49783
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1588602254
-
- CODING SYSTEM: VASTANUM
- ID: 585HB
-
- CODING SYSTEM: CLIA
- ID: 23D1018230
|
