| NAME |
PROVIDENCE VAMC |
| STATE |
RHODE ISLAND |
| STREET ADDR. 1 |
830 CHALKSTONE AVE |
| CITY |
PROVIDENCE |
| ZIP |
02908-4734 |
| OFFICIAL VA NAME |
PROVIDENCE VAMC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PROVIDENCE VAMC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1306896733
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
650 |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 830 CHALKSTONE AVE.
- CITY (CHANGED FROM): PROVIDENCE
- STATE (CHANGED FROM): RHODE ISLAND
- ZIP (CHANGED FROM): 02908-4734
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1306896733
-
- CODING SYSTEM: VASTANUM
- ID: 650
-
- CODING SYSTEM: CLIA
- ID: 41D0986930
|