| NAME |
SANDPOINT VA CLINIC |
| STATE |
IDAHO |
| STREET ADDR. 1 |
130 MCGHEE RD STE 101 |
| CITY |
KOOTENAI |
| ZIP |
83840-0040 |
| OFFICIAL VA NAME |
SANDPOINT VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
KOOTENAI VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2014-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1316338486
-
- 2016-05-23 00:00:00
- STATUS: ACTIVE
- NPI: 1316338486
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
668QD |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 420 N SECOND AVE
- CITY (CHANGED FROM): SANDPOINT
- STATE (CHANGED FROM): IDAHO
- ZIP (CHANGED FROM): 83864-1565
|
