| NAME |
FORT DODGE CBOC |
| STATE |
IOWA |
| STREET ADDR. 1 |
530 SOUTH 25th ST |
| CITY |
FORT DODGE |
| ZIP |
50501-9998 |
| OFFICIAL VA NAME |
FORT DODGE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FORT DODGE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
530 SOUTH 25th ST |
| CITY (MAILING) |
FORT DODGE |
| STATE (MAILING) |
IOWA |
| ZIP (MAILING) |
50501-9998 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1154374148
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
636GK |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1154374148
-
- CODING SYSTEM: VASTANUM
- ID: 636GK
|
