| NAME |
CUMBERLAND |
| STATE |
MARYLAND |
| STREET ADDR. 1 |
200 GLENN ST |
| CITY |
CUMBERLAND |
| ZIP |
21502-2573 |
| OFFICIAL VA NAME |
CUMBERLAND CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CUMBERLAND VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1932152642
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
613GA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 200 GLENN STREET
- CITY (CHANGED FROM): CUMBERLAND
- STATE (CHANGED FROM): MARYLAND
- ZIP (CHANGED FROM): 21502-2436
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1932152642
-
- CODING SYSTEM: VASTANUM
- ID: 613GA
-
- CODING SYSTEM: CLIA
- ID: 21D0988548
|
