JACKSON VAMC (263)    INSTITUTION (4)

Name Value
NAME JACKSON VAMC
STATE MISSISSIPPI
STREET ADDR. 1 1500 EAST WOODROW WILSON AVENUE
CITY JACKSON
ZIP 39216-5116
OFFICIAL VA NAME G.V. (SONNY) MONTGOMERY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME JACKSON VAMC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1992754543
TAXONOMY CODE
  • Hospitals
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 586
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1992754543
  • CODING SYSTEM:   VASTANUM
    ID:   586
  • CODING SYSTEM:   CLIA
    ID:   25D0987268