MARTINSVILLE VA CLINIC (3664) INSTITUTION (4)

Name	Value
NAME	MARTINSVILLE VA CLINIC
STATE	INDIANA
STREET ADDR. 1	2200 JOHN R WOODEN DR
CITY	MARTINSVILLE
ZIP	46151-1863
OFFICIAL VA NAME	MARTINSVILLE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: RICHARD L. ROUDEBUSH VAMC
BILLING FACILITY NAME	MARTINSVILLE VA CLINIC
EFFECTIVE DATE/TIME	2011-10-15 00:00:00 STATUS: ACTIVE NPI: 1578849832
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	583GC
IDENTIFIER	CODING SYSTEM: CLIA ID: 15D2028002