MERRIL LUNDMAN VA OPC (3366) INSTITUTION (4)

Name	Value
NAME	MERRIL LUNDMAN VA OPC
STATE	MONTANA
STREET ADDR. 1	1753 US HIGHWAY 2 NW
STREET ADDR. 2	SPC 3
CITY	HAVRE
ZIP	59501-3464
OFFICIAL VA NAME	MERRIL LUNDMAN VA OPC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: FORT HARRISON MEDICAL CENTER
BILLING FACILITY NAME	HAVRE VA CLINIC
EFFECTIVE DATE/TIME	2008-11-15 00:00:00 STATUS: ACTIVE NPI: 1326403650
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	MOUNTAIN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	436HC
IDENTIFIER	CODING SYSTEM: CLIA ID: 27D1099226