| NAME |
ZZSOUTH BEND VA CLINIC |
| STATE |
INDIANA |
| STREET ADDR. 1 |
333 WEST WESTERN AVENUE |
| CITY |
SOUTH BEND |
| ZIP |
46601-2215 |
| OFFICIAL VA NAME |
SOUTH BEND VA CLINIC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SOUTH BEND VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1417996299
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
610GA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1417996299
-
- CODING SYSTEM: VASTANUM
- ID: 610GA
|
