| NAME |
COOKEVILLE VA CLINIC |
| STATE |
TENNESSEE |
| STREET ADDR. 1 |
851 S WILLOW AVE, SUITE 108 |
| CITY |
COOKEVILLE |
| ZIP |
38501-4221 |
| OFFICIAL VA NAME |
COOKEVILLE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
COOKEVILLE VA CBOC |
| ST. ADDR. 1 (MAILING) |
851 S WILLOW AVE, SUITE 108 |
| CITY (MAILING) |
COOKEVILLE |
| STATE (MAILING) |
TENNESSEE |
| ZIP (MAILING) |
38501-4221 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1952353062
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
626GH |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1952353062
-
- CODING SYSTEM: VASTANUM
- ID: 626GH
|
