MEXICO CBOC (MO) (2150)    INSTITUTION (4)

Name Value
NAME MEXICO CBOC (MO)
STATE MISSOURI
STREET ADDR. 1 3460 S CLARK STREET
CITY MEXICO
ZIP 65265-4124
OFFICIAL VA NAME MEXICO CBOC (MO)
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MEXICO VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1033156864
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 589GX
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1033156864
  • CODING SYSTEM:   VASTANUM
    ID:   589GX
  • CODING SYSTEM:   CLIA
    ID:   26D1028166