TOMAH VA MOBILE CLINIC (4049) INSTITUTION (4)

Name	Value
NAME	TOMAH VA MOBILE CLINIC
STATE	WISCONSIN
STREET ADDR. 1	500 E. VETERANS ST
CITY	TOMAH
ZIP	54660-3105
OFFICIAL VA NAME	TOMAH VA MOBILE CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 12 PARENT FACILITY PARENT OF ASSOCIATION: TOMAH VAMC
BILLING FACILITY NAME	TOMAH VA MOBILE CLINIC
EFFECTIVE DATE/TIME	2015-03-09 00:00:00 STATUS: ACTIVE NPI: 1770978637 2022-03-02 00:00:00 STATUS: INACTIVE NPI: 1770978637
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	OTHER
POINTER TO AGENCY	OTHER
STATION NUMBER	676QA