BRUNSWICK COUNTY VA CLINIC (3606) INSTITUTION (4)

Name	Value
NAME	BRUNSWICK COUNTY VA CLINIC
STATE	NORTH CAROLINA
STREET ADDR. 1	18 DOCTORS CIRCLE
STREET ADDR. 2	SUITE 2
CITY	SUPPLY
ZIP	28462-4089
OFFICIAL VA NAME	BRUNSWICK COUNTY VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 6 PARENT FACILITY PARENT OF ASSOCIATION: FAYETTEVILLE NC VAMC
BILLING FACILITY NAME	SUPPLY VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1962819052
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
STATION NUMBER	565GH
IDENTIFIER	CODING SYSTEM: CLIA ID: 34D2041434