NORTHEAST PCC (3711) INSTITUTION (4)

Name	Value
NAME	NORTHEAST PCC
STATE	NEVADA
STREET ADDR. 1	4461 E CHARLESTON BLVD
CITY	LAS VEGAS
ZIP	89104-5537
OFFICIAL VA NAME	NORTHEAST PCC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 21 PARENT FACILITY PARENT OF ASSOCIATION: SOUTHERN NEVADA HCS
BILLING FACILITY NAME	NORTHEAST LAS VEGAS VA CBOC
ST. ADDR. 1 (MAILING)	PO BOX 360001
CITY (MAILING)	LAS VEGAS
STATE (MAILING)	NEVADA
ZIP (MAILING)	89036
EFFECTIVE DATE/TIME	2012-01-17 00:00:00 STATUS: ACTIVE NPI: 1821374067
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	PACIFIC
COUNTRY	USA
STATION NUMBER	593GG