| NAME |
ZZ-SANFORD CBOC |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
1403 Medical Plaza Dr. Suite 109 |
| CITY |
SANFORD |
| ZIP |
32771 |
| OFFICIAL VA NAME |
SANFORD CBOC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ORANGE CITY VA CBOC |
| ST. ADDR. 1 (MAILING) |
1403 Medical Plaza Dr. Suite 109 |
| CITY (MAILING) |
SANFORD |
| STATE (MAILING) |
FLORIDA |
| ZIP (MAILING) |
32771 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1215975735
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
673GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1215975735
-
- CODING SYSTEM: VASTANUM
- ID: 673GD
-
- CODING SYSTEM: CLIA
- ID: 10D1001500
|
