JACK C. MONTGOMERY EAST VA (3803) INSTITUTION (4)

Name	Value
NAME	JACK C. MONTGOMERY EAST VA
STATE	OKLAHOMA
STREET ADDR. 1	2414 EAST SHAWNEE RD
CITY	MUSKOGEE
ZIP	74403-1530
OFFICIAL VA NAME	JACK C. MONTGOMERY EAST VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: JACK C. MONTGOMERY VAMC
BILLING FACILITY NAME	JACK C. MONTGOMERY EAST VA OOS
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1326436676
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	623QA