DAYTON THIRD STREET VA MOBILE (3567) INSTITUTION (4)

Name	Value
NAME	DAYTON THIRD STREET VA MOBILE
STATE	OHIO
STREET ADDR. 1	4100 WEST THIRD ST
CITY	DAYTON
ZIP	45428-9000
OFFICIAL VA NAME	DAYTON THIRD STREET VA MOBILE
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: DAYTON
BILLING FACILITY NAME	DAYTON THIRD STREET VA MOBILE CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1114318144 2021-02-22 00:00:00 STATUS: INACTIVE NPI: 1114318144
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	552QB