GRAND FORKS CBOC (3375) INSTITUTION (4)

Name	Value
NAME	GRAND FORKS CBOC
STATE	NORTH DAKOTA
STREET ADDR. 1	3221 32ND AVE SOUTH, #700
CITY	GRAND FORKS
ZIP	58201-6071
OFFICIAL VA NAME	GRAND FORKS CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: FARGO VA HCS
BILLING FACILITY NAME	GRAND FORKS VA CBOC
EFFECTIVE DATE/TIME	2009-09-10 00:00:00 STATUS: ACTIVE NPI: 1811220742
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	437GI
IDENTIFIER	CODING SYSTEM: CLIA ID: 35D1104089