| NAME |
WILLIMANTIC VA CBOC |
| STATE |
CONNECTICUT |
| STREET ADDR. 1 |
1320 MAIN STREET |
| CITY |
WILLIMANTIC |
| ZIP |
06226-1940 |
| OFFICIAL VA NAME |
Willimantic VA Clinic |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WILLIMANTIC VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1760421630
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
689GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1760421630
-
- CODING SYSTEM: VASTANUM
- ID: 689GC
-
- CODING SYSTEM: CLIA
- ID: 07D1010389
|
