LIBERAL CBOC (2088)    INSTITUTION (4)

Name Value
NAME LIBERAL CBOC
STATE KANSAS
STREET ADDR. 1 555 W 15th ST
CITY LIBERAL
ZIP 67901-2461
OFFICIAL VA NAME LIBERAL CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LIBERAL VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1912954942
  • 2021-08-26 00:00:00
    STATUS:   INACTIVE
    NPI:   1912954942
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 589G3
HISTORY
  • EFFECTIVE DATE:   2001-10-01 00:00:00
    REALIGNED FROM:   ZZ LIBERAL CBOC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1912954942
  • CODING SYSTEM:   VASTANUM
    ID:   589G3