| NAME |
MASON CITY CBOC |
| STATE |
IOWA |
| STREET ADDR. 1 |
478 TIFFANY DR |
| CITY |
MASON CITY |
| ZIP |
50401-1535 |
| OFFICIAL VA NAME |
MASON CITY COMMINITY BASED OUTPATIENT CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
MASON CITY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1528005402
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
636GC |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1528005402
-
- CODING SYSTEM: VASTANUM
- ID: 636GC
-
- CODING SYSTEM: CLIA
- ID: 16D1012364
|
