| NAME |
MILO C. HUEMPFNER CBOC |
| STATE |
WISCONSIN |
| STREET ADDR. 1 |
2851 UNIVERSITY AVE |
| CITY |
GREEN BAY |
| ZIP |
54311-5855 |
| OFFICIAL VA NAME |
MILO C. HUEMPFNER CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GREEN BAY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1003861014
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
695GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1003861014
-
- CODING SYSTEM: VASTANUM
- ID: 695GD
-
- CODING SYSTEM: CLIA
- ID: 52D1033946
|
