LOWELL OPC (184)    INSTITUTION (4)

Name Value
NAME LOWELL OPC
STATE MASSACHUSETTS
STREET ADDR. 1 130 MARSHALL ROAD
CITY LOWELL
ZIP 01852-5130
OFFICIAL VA NAME VA BOSTON HEALTHCARE SYSTEM - LOWELL DIVISION
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LOWELL VA CBOC
ST. ADDR. 1 (MAILING) 130 MARSHALL ROAD
CITY (MAILING) LOWELL
STATE (MAILING) MASSACHUSETTS
ZIP (MAILING) 01852-5130
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1447290176
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 523BY
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1447290176
  • CODING SYSTEM:   VASTANUM
    ID:   523BY
  • CODING SYSTEM:   CLIA
    ID:   22D0989788