| NAME |
JEFFERSON CITY, MO CBOC |
| STATE |
MISSOURI |
| STREET ADDR. 1 |
3430 W. EDGEWOOD DRIVE |
| CITY |
JEFFERSON CITY |
| ZIP |
65109-6961 |
| OFFICIAL VA NAME |
JEFFERSON CITY, MO CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
JEFFERSON CITY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2008-09-15 00:00:00
- STATUS: ACTIVE
- NPI: 1134375546
-
- 2019-01-29 00:00:00
- STATUS: ACTIVE
- NPI: 1134375546
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
589G8 |
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 26D1087806
|
