| NAME |
ZZ-SACO MAINE CBOC |
| STATE |
MAINE |
| STREET ADDR. 1 |
655 MAIN STREET |
| CITY |
SACO |
| ZIP |
04072-1543 |
| OFFICIAL VA NAME |
SACO MAINE CBOC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SACO VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1710929369
-
- 2022-03-01 00:00:00
- STATUS: INACTIVE
- NPI: 1710929369
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
402GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1710929369
-
- CODING SYSTEM: VASTANUM
- ID: 402GD
-
- CODING SYSTEM: CLIA
- ID: 20D1008066
|
