| NAME |
PARAGOULD CBOC |
| STATE |
ARKANSAS |
| STREET ADDR. 1 |
2420 LINWOOD DRIVE SUITE 3 |
| CITY |
PARAGOULD |
| ZIP |
72450-6122 |
| OFFICIAL VA NAME |
PARAGOULD VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PARAGOULD VA CBOC |
| ST. ADDR. 1 (MAILING) |
2420 LINWOOD DRIVE SUITE 3 |
| CITY (MAILING) |
PARAGOULD |
| STATE (MAILING) |
ARKANSAS |
| ZIP (MAILING) |
72450-6122 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1508809948
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
657GG |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1508809948
-
- CODING SYSTEM: VASTANUM
- ID: 657GG
-
- CODING SYSTEM: CLIA
- ID: 04D0987315
|
