LT. COL CLEMENT VAN WAGONER VA (3926) INSTITUTION (4)

Name	Value
NAME	LT. COL CLEMENT VAN WAGONER VA
STATE	MICHIGAN
STREET ADDR. 1	180 N. STATE AVE
CITY	ALPENA
ZIP	49707-2847
OFFICIAL VA NAME	LT. COL CLEMENT VAN WAGONER VA
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: ALEDA E. LUTZ VAMC
BILLING FACILITY NAME	ALPENA VA CBOC
EFFECTIVE DATE/TIME	2008-09-15 00:00:00 STATUS: ACTIVE NPI: 1952550931
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	655GD
IDENTIFIER	CODING SYSTEM: CLIA ID: 23D1090371