COUDERSPORT VA CLINIC (3493) INSTITUTION (4)

Name	Value
NAME	COUDERSPORT VA CLINIC
STATE	PENNSYLVANIA
STREET ADDR. 1	24 MAPLE VIEW LANE, #2
CITY	COUDERSPORT
ZIP	16915-9527
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 2 PARENT FACILITY PARENT OF ASSOCIATION: BATH VA MEDICAL CENTER
BILLING FACILITY NAME	COUDERSPORT VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1659779254 2023-11-06 00:00:00 STATUS: INACTIVE NPI: 1659779254
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	528QE