WATERTOWN VA CBOC (3383) INSTITUTION (4)

Name	Value
NAME	WATERTOWN VA CBOC
STATE	SOUTH DAKOTA
STREET ADDR. 1	4 19TH STREET NORTHEAST
CITY	WATERTOWN
ZIP	57201-3936
OFFICIAL VA NAME	WATERTOWN CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: SIOUX FALLS VA HCS
BILLING FACILITY NAME	WATERTOWN VA CLINIC
EFFECTIVE DATE/TIME	2009-06-29 00:00:00 STATUS: ACTIVE NPI: 1679709265
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	438GF
IDENTIFIER	CODING SYSTEM: CLIA ID: 43D1107504