| NAME |
GILLETTE VA CLINIC |
| STATE |
WYOMING |
| STREET ADDR. 1 |
604 EXPRESS DRIVE |
| CITY |
GILLETTE |
| ZIP |
82718-4112 |
| OFFICIAL VA NAME |
GILLETTE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GILLETTE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
604 EXPRESS DRIVE |
| CITY (MAILING) |
GILLETTE |
| STATE (MAILING) |
WYOMING |
| ZIP (MAILING) |
82718-4112 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1518911940
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
666GE |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1518911940
-
- CODING SYSTEM: VASTANUM
- ID: 666GE
-
- CODING SYSTEM: CLIA
- ID: 53D1014078
|
