| NAME |
CADILLAC VA CLINIC |
| STATE |
MICHIGAN |
| STREET ADDR. 1 |
1905 N MITCHELL ST |
| CITY |
CADILLAC |
| ZIP |
49601-1139 |
| OFFICIAL VA NAME |
CADILLAC VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CADILLAC VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2011-06-01 00:00:00
- STATUS: ACTIVE
- NPI: 1194010173
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
655GG |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 1909 NORTH MITCHELL ST
- CITY (CHANGED FROM): CADILLAC
- STATE (CHANGED FROM): MICHIGAN
- ZIP (CHANGED FROM): 49601-1139
|
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 23D2023166
|
