| NAME |
CASA GRANDE CBOC |
| STATE |
ARIZONA |
| STREET ADDR. 1 |
1876 E. SABIN DR, BLDG A SUITE 15 |
| CITY |
CASA GRANDE |
| ZIP |
85122-6198 |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CASA GRANDE VA CBOC |
| ST. ADDR. 1 (MAILING) |
1876 E. SABIN DR, BLDG A SUITE 15 |
| CITY (MAILING) |
CASA GRANDE |
| STATE (MAILING) |
ARIZONA |
| ZIP (MAILING) |
85122-6198 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1083665871
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| TIMEZONE EXCEPTION |
SST Only |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
678GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1083665871
-
- CODING SYSTEM: VASTANUM
- ID: 678GC
-
- CODING SYSTEM: CLIA
- ID: 03D1017071
|
