S PRINCE GEORGES CITY VA CLINC (4068) INSTITUTION (4)

Name	Value
NAME	S PRINCE GEORGES CITY VA CLINC
STATE	MARYLAND
STREET ADDR. 1	5801 ALLENTOWN RD, #103,104, & 106
CITY	CAMP SPRINGS
ZIP	20746-4563
OFFICIAL VA NAME	S PRINCE GEORGES CITY VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 5 PARENT FACILITY PARENT OF ASSOCIATION: WASHINGTON VA MEDICAL CENTER
BILLING FACILITY NAME	CAMP SPRINGS VA CLINIC
EFFECTIVE DATE/TIME	2011-10-11 00:00:00 STATUS: ACTIVE NPI: 1932483443
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	688GE
IDENTIFIER	CODING SYSTEM: CLIA ID: 21D2032394