PHOENIX MIDTOWN VA CLINIC (3888) INSTITUTION (4)

Name	Value
NAME	PHOENIX MIDTOWN VA CLINIC
STATE	ARIZONA
STREET ADDR. 1	5040 N. 15TH AVENUE
CITY	PHOENIX
ZIP	85015-3328
OFFICIAL VA NAME	PHOENIX MIDTOWN VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 22 PARENT FACILITY PARENT OF ASSOCIATION: PHOENIX VAMC
BILLING FACILITY NAME	PHOENIX 2 VA CLINIC
EFFECTIVE DATE/TIME	2016-12-21 00:00:00 STATUS: ACTIVE NPI: 1174065791
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	MOUNTAIN
COUNTRY	USA
TIMEZONE EXCEPTION	SST Only
STATION NUMBER	644GH
IDENTIFIER	CODING SYSTEM: CLIA ID: 03D2125483