ST. MARYS VA CLINIC (3627) INSTITUTION (4)

Name	Value
NAME	ST. MARYS VA CLINIC
STATE	GEORGIA
STREET ADDR. 1	2603 OSBORNE RD, SUITE E
CITY	SAINT MARYS
ZIP	31558-8907
OFFICIAL VA NAME	ST. MARYS VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 8 PARENT FACILITY PARENT OF ASSOCIATION: N. FLORIDA/S. GEORGIA HCS
BILLING FACILITY NAME	SAINT MARYS VA CLINIC
EFFECTIVE DATE/TIME	2008-09-23 00:00:00 STATUS: ACTIVE NPI: 1710137203
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	573GJ
IDENTIFIER	CODING SYSTEM: CLIA ID: 11D1089804