WILLISTON CBOC (3372) INSTITUTION (4)

Name	Value
NAME	WILLISTON CBOC
STATE	NORTH DAKOTA
STREET ADDR. 1	1542 16TH STREET WEST, SUITE 300
CITY	WILLISTON
ZIP	58801-3888
OFFICIAL VA NAME	WILLISTON CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: FARGO VA HCS
BILLING FACILITY NAME	WILLISTON VA CLINIC
EFFECTIVE DATE/TIME	2007-10-09 00:00:00 STATUS: ACTIVE NPI: 1598952194
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	437GF
IDENTIFIER	CODING SYSTEM: CLIA ID: 35D2014194