| NAME |
FORT DETRICK VA CLINIC |
| STATE |
MARYLAND |
| STREET ADDR. 1 |
1433 PORTER STREET |
| CITY |
FREDERICK |
| ZIP |
21702-5000 |
| OFFICIAL VA NAME |
FORT DETRICK VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FREDERICK VA CLINIC |
| ST. ADDR. 1 (MAILING) |
1433 PORTER STREET |
| CITY (MAILING) |
MARTINSBURG |
| STATE (MAILING) |
WEST VIRGINIA |
| ZIP (MAILING) |
21702-5000 |
| EFFECTIVE DATE/TIME |
-
- 2011-06-24 00:00:00
- STATUS: ACTIVE
- NPI: 1215224399
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
613GG |
