STATESBORO VA CLINIC (3447) INSTITUTION (4)

Name	Value
NAME	STATESBORO VA CLINIC
STATE	GEORGIA
STREET ADDR. 1	658 NORTHSIDE DR EAST, #B
CITY	STATESBORO
ZIP	30458-4828
OFFICIAL VA NAME	STATESBORO VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 7 PARENT FACILITY PARENT OF ASSOCIATION: AUGUSTA VAMC
BILLING FACILITY NAME	STATESBORO VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1437547569
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	509QA
IDENTIFIER	CODING SYSTEM: CLIA ID: ID:11D2054635