| NAME |
CASPER, WY CBOC |
| STATE |
WYOMING |
| STREET ADDR. 1 |
6000 E 2ND ST FL 1 |
| CITY |
CASPER |
| ZIP |
82609-4336 |
| OFFICIAL VA NAME |
CASPER CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CASPER VA CLINIC |
| ST. ADDR. 1 (MAILING) |
4140 S. POPLAR STREET |
| CITY (MAILING) |
CASPER |
| STATE (MAILING) |
WYOMING |
| ZIP (MAILING) |
82601-6104 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1538110226
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
666GB |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1538110226
-
- CODING SYSTEM: VASTANUM
- ID: 666GB
-
- CODING SYSTEM: CLIA
- ID: 53D1014073
|
