| NAME |
PORT RICHEY VA CLINIC |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
7900 LITTLE RD |
| CITY |
NEW PORT RICHEY |
| ZIP |
34654-5405 |
| OFFICIAL VA NAME |
PORT RICHEY VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PORT RICHEY VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1669419149
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
673BZ |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 9912 LITTLE ROAD
- CITY (CHANGED FROM): NEW PORT RICHEY
- STATE (CHANGED FROM): FLORIDA
- ZIP (CHANGED FROM): 34654-3419
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1669419149
-
- CODING SYSTEM: VASTANUM
- ID: 673BZ
-
- CODING SYSTEM: CLIA
- ID: 10D0987728
|
