| NAME |
SHOW LOW CBOC |
| STATE |
ARIZONA |
| STREET ADDR. 1 |
2450 SHOW LOW LAKE RD STE 1 |
| CITY |
SHOW LOW |
| ZIP |
85901-7953 |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SHOW LOW VA CBOC |
| ST. ADDR. 1 (MAILING) |
2450 SHOW LOW LAKE RD STE 1 |
| CITY (MAILING) |
SHOW LOW |
| STATE (MAILING) |
ARIZONA |
| ZIP (MAILING) |
85901-7953 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1205874351
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| TIMEZONE EXCEPTION |
SST Only |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
644GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1205874351
-
- CODING SYSTEM: VASTANUM
- ID: 644GB
-
- CODING SYSTEM: CLIA
- ID: 03D1002387
|
