SCOTT AFB VA CLINIC (3954) INSTITUTION (4)

Name	Value
NAME	SCOTT AFB VA CLINIC
STATE	ILLINOIS
STREET ADDR. 1	310 WEST LOSEY STREET
STREET ADDR. 2	375 MEDICAL GROUP
CITY	SCOTT AIR FORCE BASE
ZIP	62225-5250
OFFICIAL VA NAME	SCOTT AFB VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 15 PARENT FACILITY PARENT OF ASSOCIATION: ST. LOUIS MO VAMC-JC DIVISION
BILLING FACILITY NAME	SCOTT AIR FORCE BASE VA CLINIC
EFFECTIVE DATE/TIME	2015-01-26 00:00:00 STATUS: ACTIVE NPI: 1093192908
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	657QE