ZZ-GOSHEN VA CLINIC (3751) INSTITUTION (4)

Name	Value
NAME	ZZ-GOSHEN VA CLINIC
STATE	INDIANA
STREET ADDR. 1	2606 PEDDLERS VILLAGE RD, #210
CITY	GOSHEN
ZIP	46526-1004
OFFICIAL VA NAME	ZZ-GOSHEN VA CLINIC
INACTIVE FACILITY FLAG	INACTIVE
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: MARION VA MEDICAL CENTER
BILLING FACILITY NAME	GOSHEN VA CLINIC
EFFECTIVE DATE/TIME	2008-10-01 00:00:00 STATUS: ACTIVE NPI: 1528217361 2024-01-22 00:00:00 STATUS: INACTIVE NPI: 1528217361
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	610GC