POCOMOKE CITY VA CLINIC (2082)    INSTITUTION (4)

Name Value
NAME POCOMOKE CITY VA CLINIC
STATE MARYLAND
STREET ADDR. 1 1701 MARKET PLACE #211
CITY POCOMOKE CITY
ZIP 21851-1738
OFFICIAL VA NAME POCOMOKE CITY VA CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME POCOMOKE CITY VA CLINIC
ST. ADDR. 1 (MAILING) 101 MARKET STREET
CITY (MAILING) POCOMOKE CITY
STATE (MAILING) MARYLAND
ZIP (MAILING) 21851-1042
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1326087719
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 512GE
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1326087719
  • CODING SYSTEM:   VASTANUM
    ID:   512GE
  • CODING SYSTEM:   CLIA
    ID:   21D0987067