| NAME |
POCATELLO VA CLINIC |
| STATE |
IDAHO |
| STREET ADDR. 1 |
500 S. 11TH AVENUE |
| CITY |
POCATELLO |
| ZIP |
83201-4835 |
| OFFICIAL VA NAME |
POCATELLO VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
POCATELLO VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1487691002
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
660GA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1487691002
-
- CODING SYSTEM: VASTANUM
- ID: 660GA
-
- CODING SYSTEM: CLIA
- ID: 13D1013966
|
