| NAME |
ELY VA CLINIC |
| STATE |
NEVADA |
| STREET ADDR. 1 |
#6 STEPTOE CIRCLE |
| STREET ADDR. 2 |
WM. B RIRIE CLINIC |
| CITY |
ELY |
| ZIP |
89301-2692 |
| OFFICIAL VA NAME |
ELY VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ELY VA CLINIC |
| ST. ADDR. 1 (MAILING) |
#6 STEPTOE CIRCLE |
| CITY (MAILING) |
ELY |
| STATE (MAILING) |
NEVADA |
| ZIP (MAILING) |
89301-2692 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: INACTIVE
- NPI: 1174576235
-
- 2018-07-01 00:00:00
- STATUS: ACTIVE
- NPI: 1073094884
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
660GC |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): #6 STEPTOE CIRCLE
- STREET ADDR. 2 (CHANGED FROM): WM. B RIRIE CLINIC
- CITY (CHANGED FROM): ELY
- STATE (CHANGED FROM): NEVADA
- ZIP (CHANGED FROM): 89301-2692
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1174576235
-
- CODING SYSTEM: VASTANUM
- ID: 660GC
|
