| NAME | 
LT COL LUKE WEATHERS JR VAMC | 
| STATE | 
TENNESSEE | 
| STREET ADDR. 1 | 
116 N PAULINE ST | 
| CITY | 
MEMPHIS | 
| ZIP | 
38104-1005 | 
| OFFICIAL VA NAME | 
LT COL LUKE WEATHERS JR VAMC | 
| STATUS | 
National | 
| ASSOCIATIONS | 
 | 
| BILLING FACILITY NAME | 
MEMPHIS VAMC | 
| EFFECTIVE DATE/TIME | 
- 
- 2007-01-08 00:00:00
 
- STATUS:    ACTIVE
 
- NPI:    1255381695
 
 
 
 | 
| TAXONOMY CODE | 
 | 
| LOCATION TIMEZONE | 
CENTRAL | 
| COUNTRY | 
USA | 
| AGENCY CODE | 
VA | 
| POINTER TO AGENCY | 
VA | 
| STATION NUMBER | 
614 | 
| HISTORY | 
- 
- STREET ADDR. 1 (CHANGED FROM):    1030 JEFFERSON AVENUE
 
- CITY (CHANGED FROM):    MEMPHIS
 
- STATE (CHANGED FROM):    TENNESSEE
 
- ZIP (CHANGED FROM):    38104-2127
 
 
 
 | 
| IDENTIFIER | 
- 
- CODING SYSTEM:    NPI
 
- ID:    1255381695
 
 
- 
- CODING SYSTEM:    VASTANUM
 
- ID:    614
 
 
- 
- CODING SYSTEM:    CLIA
 
- ID:    44D0987294
 
 
 
 |