NORTHPORT 1 VA MOBILE CLINIC (3833) INSTITUTION (4)

Name	Value
NAME	NORTHPORT 1 VA MOBILE CLINIC
STATE	NEW YORK
STREET ADDR. 1	79 MIDDLEVILLE ROAD
CITY	NORTHPORT
ZIP	11768-2200
OFFICIAL VA NAME	NORTHPORT 1 VA MOBILE CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 2 PARENT FACILITY PARENT OF ASSOCIATION: NORTHPORT VAMC
BILLING FACILITY NAME	NORTHPORT 1 VA MOBILE OOS
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1508264151
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
STATION NUMBER	632QA