BRUCE B DOWNS BLVD VA CLINIC (4024) INSTITUTION (4)

Name	Value
NAME	BRUCE B DOWNS BLVD VA CLINIC
STATE	FLORIDA
STREET ADDR. 1	12210 BRUCE B DOWNS BLVD
CITY	TAMPA
ZIP	33612-9211
OFFICIAL VA NAME	BRUCE B DOWNS BLVD VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 8 PARENT FACILITY PARENT OF ASSOCIATION: TAMPA FL VAMC
BILLING FACILITY NAME	BRUCE B. DOWNS BOULEVARD VA OOS
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1811395072
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	673QH
IDENTIFIER	CODING SYSTEM: CLIA ID: 10D2004736