JACKSON VA CLINIC (3766) INSTITUTION (4)

Name	Value
NAME	JACKSON VA CLINIC
STATE	TENNESSEE
STREET ADDR. 1	180 OLD HICKORY BLVD, SUITE A
CITY	JACKSON
ZIP	38305-2562
OFFICIAL VA NAME	JACKSON VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 9 PARENT FACILITY PARENT OF ASSOCIATION: LT COL LUKE WEATHERS JR VAMC
BILLING FACILITY NAME	JACKSON VA CBOC
EFFECTIVE DATE/TIME	2008-12-15 00:00:00 STATUS: ACTIVE NPI: 1205072436
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	614GG