| NAME |
WISCONSIN RAPIDS |
| STATE |
WISCONSIN |
| STREET ADDR. 1 |
700 HALE ST |
| CITY |
WISCONSIN RAPIDS |
| ZIP |
54495-2787 |
| OFFICIAL VA NAME |
WISCONSIN RAPIDS CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WISCONSIN RAPIDS VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1881634616
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
676GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1881634616
-
- CODING SYSTEM: VASTANUM
- ID: 676GD
-
- CODING SYSTEM: CLIA
- ID: 52D2005047
|
