| NAME |
PERRY OUTREACH CLINIC |
| STATE |
GEORGIA |
| STREET ADDR. 1 |
1309 MAIN ST |
| CITY |
PERRY |
| ZIP |
31069-3581 |
| OFFICIAL VA NAME |
PERRY OUTREACH CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PERRY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2008-11-07 00:00:00
- STATUS: ACTIVE
- NPI: 1578948105
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
557HA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2370 SOUTH HOUSTON LAKE ROAD
- CITY (CHANGED FROM): KATHLEEN
- STATE (CHANGED FROM): GEORGIA
- ZIP (CHANGED FROM): 31047-5400
|
