| NAME |
GAINESVILLE 1 VA CLINIC |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
5465 SW 34TH ST |
| CITY |
GAINESVILLE |
| ZIP |
32608-5032 |
| OFFICIAL VA NAME |
GAINESVILLE 1 VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
GAINESVILLE 6 VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2014-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1912305251
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
573QF |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 825 NORTHWEST 23RD AVE
- CITY (CHANGED FROM): GAINESVILLE
- STATE (CHANGED FROM): FLORIDA
- ZIP (CHANGED FROM): 32609-3574
|
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 10D2283878
|
