| NAME |
ST. GEORGE VA CLINIC |
| STATE |
UTAH |
| STREET ADDR. 1 |
585 E RIVERSIDE DR STE 300 |
| CITY |
ST. GEORGE |
| ZIP |
84790-7141 |
| OFFICIAL VA NAME |
ST. GEORGE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ST. GEORGE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1184664559
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
660GG |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 230 NORTH 1680 EAST, BLDG N
- CITY (CHANGED FROM): ST. GEORGE
- STATE (CHANGED FROM): UTAH
- ZIP (CHANGED FROM): 84790-2579
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1184664559
-
- CODING SYSTEM: VASTANUM
- ID: 660GG
-
- CODING SYSTEM: CLIA
- ID: 46D1013969
|
