SHREVEPORT VAMC (365)    INSTITUTION (4)

Name Value
NAME SHREVEPORT VAMC
STATE LOUISIANA
STREET ADDR. 1 510 EAST STONER AVENUE
CITY SHREVEPORT
ZIP 71101-4243
OFFICIAL VA NAME OVERTON BROOKS VA MEDICAL CENTER
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SHREVEPORT VAMC
ST. ADDR. 1 (MAILING) 510 E. STONER AVE.
CITY (MAILING) SHREVEPORT
STATE (MAILING) LOUISIANA
ZIP (MAILING) 71101-4243
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1891745626
TAXONOMY CODE
  • Hospitals
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 667
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1891745626
  • CODING SYSTEM:   VASTANUM
    ID:   667
  • CODING SYSTEM:   CLIA
    ID:   19D0987270