DICKINSON VA CLINIC (3376) INSTITUTION (4)

Name	Value
NAME	DICKINSON VA CLINIC
STATE	NORTH DAKOTA
STREET ADDR. 1	766 ELKS DRIVE
STREET ADDR. 2	SUITE 6H
CITY	DICKINSON
ZIP	58601-2915
OFFICIAL VA NAME	DICKINSON VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: FARGO VA HCS
BILLING FACILITY NAME	DICKINSON VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1023426913
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	437GJ
IDENTIFIER	CODING SYSTEM: CLIA ID: 35D2013957