ST. JOHN VA OPC (2270) INSTITUTION (4)

Name	Value
NAME	ST. JOHN VA OPC
STATE	LOUISIANA
STREET ADDR. 1	4004 WEST AIRLINE HWY
CITY	RESERVE
ZIP	70084-5712
OFFICIAL VA NAME	ST. JOHN VA OUTPATIENT CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: SE LOUISIANA VETERANS HCS
BILLING FACILITY NAME	RESERVE VA CBOC
EFFECTIVE DATE/TIME	2007-03-26 00:00:00 STATUS: ACTIVE NPI: 1760535058
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	629GD
IDENTIFIER	CODING SYSTEM: VASTANUM ID: 629GD