GRANGEVILLE VA CLINIC (4063) INSTITUTION (4)

Name	Value
NAME	GRANGEVILLE VA CLINIC
STATE	IDAHO
STREET ADDR. 1	711 WEST NORTH STREET
CITY	GRANGEVILLE
ZIP	83530-1349
OFFICIAL VA NAME	GRANGEVILLE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 20 PARENT FACILITY PARENT OF ASSOCIATION: JONATHAN M. WAINWRIGHT VAMC
BILLING FACILITY NAME	GRANGEVILLE VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: INACTIVE NPI: 1093106171
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	PACIFIC
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	687QA