| NAME |
TRIDENT 2 VA CLINIC |
| STATE |
SOUTH CAROLINA |
| STREET ADDR. 1 |
9237 UNIVERSITY BLVD |
| CITY |
NORTH CHARLESTON |
| ZIP |
29406-9189 |
| OFFICIAL VA NAME |
TRIDENT 2 VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
NORTH CHARLESTON 1 VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2014-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1255729398
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
534QB |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 9229 UNIVERSITY BLVD
- CITY (CHANGED FROM): NORTH CHARLESTON
- STATE (CHANGED FROM): SOUTH CAROLINA
- ZIP (CHANGED FROM): 29406-9150
|
