| NAME |
QUAD CITIES VA CLINIC |
| STATE |
IOWA |
| STREET ADDR. 1 |
2826 WEST LOCUST STREET |
| CITY |
DAVENPORT |
| ZIP |
52804-3354 |
| OFFICIAL VA NAME |
QUAD CITIES VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
DAVENPORT 1 VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1861443590
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
636GF |
| HISTORY |
-
- EFFECTIVE DATE: 2000-07-01 00:00:00
- REALIGNED FROM: ZZ BETTENDORF
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1861443590
-
- CODING SYSTEM: VASTANUM
- ID: 636GF
-
- CODING SYSTEM: CLIA
- ID: 16D1002330
|
