GAINESVILLE 64TH ST 3 VA CLINC (3638) INSTITUTION (4)

Name	Value
NAME	GAINESVILLE 64TH ST 3 VA CLINC
STATE	FLORIDA
STREET ADDR. 1	5571 SOUTHWEST 64TH ST
CITY	GAINESVILLE
ZIP	32608-9608
OFFICIAL VA NAME	GAINESVILLE 64TH ST 3 VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 8 PARENT FACILITY PARENT OF ASSOCIATION: N. FLORIDA/S. GEORGIA HCS
BILLING FACILITY NAME	GAINESVILLE 5 VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1811395130
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	573QE
IDENTIFIER	CODING SYSTEM: CLIA ID: 10D1092415