LAKE CITY VA MEDICAL CENTER (268)    INSTITUTION (4)

Name Value
NAME LAKE CITY VA MEDICAL CENTER
STATE FLORIDA
STREET ADDR. 1 619 S. MARION AVE.
CITY LAKE CITY
ZIP 32025-5808
OFFICIAL VA NAME LAKE CITY VA MEDICAL CENTER
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LAKE CITY VAMC
ST. ADDR. 1 (MAILING) 619 S. MARION AVE.
CITY (MAILING) LAKE CITY
STATE (MAILING) FLORIDA
ZIP (MAILING) 32025-5808
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1508815630
TAXONOMY CODE
  • Hospitals
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 573A4
HISTORY
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1508815630
  • CODING SYSTEM:   VASTANUM
    ID:   573A4
  • CODING SYSTEM:   CLIA
    ID:   10D0987722