ENTERPRISE WAY VA CLINIC (3952) INSTITUTION (4)

Name	Value
NAME	ENTERPRISE WAY VA CLINIC
STATE	ILLINOIS
STREET ADDR. 1	1301 ENTERPRISE WAY
CITY	MARION
ZIP	62959-4442
OFFICIAL VA NAME	ENTERPRISE WAY VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 15 PARENT FACILITY PARENT OF ASSOCIATION: MARION IL VAMC
BILLING FACILITY NAME	ENTERPRISE WAY VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1588054738 2021-02-17 00:00:00 STATUS: INACTIVE NPI: 1588054738
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	657QC