PETERSBURG VA CLINIC (1542)    INSTITUTION (4)

Name Value
NAME PETERSBURG VA CLINIC
STATE WEST VIRGINIA
STREET ADDR. 1 15 GRANT STREET
CITY PETERSBURG
ZIP 26847-1613
OFFICIAL VA NAME PETERSBURG VA CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME PETERSBURG VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1912941501
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 613GE
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1912941501
  • CODING SYSTEM:   VASTANUM
    ID:   613GE