EASTERN KS HCS LEAVENWORTH DIV (2034)    INSTITUTION (4)

Name Value
NAME EASTERN KS HCS LEAVENWORTH DIV
STATE KANSAS
STREET ADDR. 1 4101 S 4TH ST
CITY LEAVENWORTH
ZIP 66048-5014
OFFICIAL VA NAME DWIGHT D. EISENHOWER VAMC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LEAVENWORTH VAMC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1497704944
TAXONOMY CODE
  • Hospitals
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 589A6
HISTORY
  • EFFECTIVE DATE:   2001-05-21 00:00:00
    REALIGNED FROM:   ZZ LEAVENWORTH VAMC
  • STREET ADDR. 1 (CHANGED FROM):   4101 S 4TH STREET TRAFFICWAY
    CITY (CHANGED FROM):   LEAVENWORTH
    STATE (CHANGED FROM):   KANSAS
    ZIP (CHANGED FROM):   66048-5014
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1497704944
  • CODING SYSTEM:   VASTANUM
    ID:   589A6
  • CODING SYSTEM:   CLIA
    ID:   17D0987875