FOURTH ST VA CLINIC (3883) INSTITUTION (4)

Name	Value
NAME	FOURTH ST VA CLINIC
STATE	PENNSYLVANIA
STREET ADDR. 1	213 NORTH 4TH STREET
CITY	PHILADELPHIA
ZIP	19106-1801
OFFICIAL VA NAME	FOURTH ST VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 4 PARENT FACILITY PARENT OF ASSOCIATION: PHILADELPHIA, PA VAMC
BILLING FACILITY NAME	FOURTH STREET VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1316324486
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
STATION NUMBER	642QB