WAGNER CBOC (3382) INSTITUTION (4)

Name	Value
NAME	WAGNER CBOC
STATE	SOUTH DAKOTA
STREET ADDR. 1	400 W HIGHWAY 46
CITY	WAGNER
ZIP	57380-9369
OFFICIAL VA NAME	WAGNER CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: SIOUX FALLS VA HCS
BILLING FACILITY NAME	WAGNER VA CLINIC
EFFECTIVE DATE/TIME	2010-02-01 00:00:00 STATUS: ACTIVE NPI: 1982934691
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	438GE
IDENTIFIER	CODING SYSTEM: CLIA ID: 43D2033506