| NAME |
FARMINGTON VA CLINIC |
| STATE |
MISSOURI |
| STREET ADDR. 1 |
1580 W COLUMBIA ST |
| CITY |
FARMINGTON |
| ZIP |
63640-3512 |
| OFFICIAL VA NAME |
FARMINGTON VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FARMINGTON VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1992745277
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
657GI |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 1580 W COLUMBIA DRIVE
- CITY (CHANGED FROM): FARMINGTON
- STATE (CHANGED FROM): MISSOURI
- ZIP (CHANGED FROM): 63640-3512
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1992745277
-
- CODING SYSTEM: VASTANUM
- ID: 657GI
-
- CODING SYSTEM: CLIA
- ID: 26D1001743
|
