FORT WAYNE VA CLINIC (3754) INSTITUTION (4)

Name	Value
NAME	FORT WAYNE VA CLINIC
STATE	INDIANA
STREET ADDR. 1	2500 EAST STATE BLVD
CITY	FORT WAYNE
ZIP	46805-4728
OFFICIAL VA NAME	FORT WAYNE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: FORT WAYNE VA MEDICAL CENTER
BILLING FACILITY NAME	FORT WAYNE VA CLINIC
EFFECTIVE DATE/TIME	2015-02-14 00:00:00 STATUS: ACTIVE NPI: 1346629367
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	610QA