| NAME |
SALEM MO CBOC |
| STATE |
MISSOURI |
| STREET ADDR. 1 |
35629 HWY 72 NORTH SUITE 3 |
| CITY |
SALEM |
| ZIP |
65560-7217 |
| OFFICIAL VA NAME |
SALEM VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SALEM VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1033151980
-
- 2021-08-06 00:00:00
- STATUS: INACTIVE
- NPI: 1033151980
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
657GN |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1033151980
-
- CODING SYSTEM: VASTANUM
- ID: 657GN
|
