| NAME |
HAGERSTOWN VA CLINIC |
| STATE |
MARYLAND |
| STREET ADDR. 1 |
1101 OPAL COURT |
| CITY |
HAGERSTOWN |
| ZIP |
21740-5941 |
| OFFICIAL VA NAME |
HAGERSTOWN VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
HAGERSTOWN VA CLINIC |
| ST. ADDR. 1 (MAILING) |
1101 OPAL COURT |
| CITY (MAILING) |
HAGERSTOWN |
| STATE (MAILING) |
MARYLAND |
| ZIP (MAILING) |
21740-5941 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1649226689
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
613GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1649226689
-
- CODING SYSTEM: VASTANUM
- ID: 613GB
-
- CODING SYSTEM: CLIA
- ID: 21D0988545
|
