| NAME |
CANTON CBOC |
| STATE |
OHIO |
| STREET ADDR. 1 |
733 MARKET AVENUE S |
| CITY |
CANTON |
| ZIP |
44702-2165 |
| OFFICIAL VA NAME |
CANTON CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CANTON VA CBOC |
| ST. ADDR. 1 (MAILING) |
733 MARKET AVENUE S |
| CITY (MAILING) |
CANTON |
| STATE (MAILING) |
OHIO |
| ZIP (MAILING) |
44702-2165 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1487606018
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
541BY |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1487606018
-
- CODING SYSTEM: VASTANUM
- ID: 541BY
-
- CODING SYSTEM: CLIA
- ID: 36D0988529
|
