FAYETTEVILLE 2 MOBILE CLINIC (3618)    INSTITUTION (4)

Name Value
NAME FAYETTEVILLE 2 MOBILE CLINIC
STATE NORTH CAROLINA
STREET ADDR. 1 2300 RAMSEY STREET
CITY FAYETTEVILLE
ZIP 28301-3856
OFFICIAL VA NAME FAYETTEVILLE 2 MOBILE CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME FAYETTEVILLE 2 VA MOBILE CLINIC
EFFECTIVE DATE/TIME
  • 2016-05-01 00:00:00
    STATUS:   ACTIVE
    NPI:   1649721309
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
STATION NUMBER 565QC