MONTGOMERY COUNTY VA CLINIC (4069) INSTITUTION (4)

Name	Value
NAME	MONTGOMERY COUNTY VA CLINIC
STATE	MARYLAND
STREET ADDR. 1	15810 GAITHER DRIVE SUITE 130
CITY	GAITHERSBURG
ZIP	20877-1429
OFFICIAL VA NAME	MONTGOMERY COUNTY VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 5 PARENT FACILITY PARENT OF ASSOCIATION: WASHINGTON VA MEDICAL CENTER
BILLING FACILITY NAME	GAITHERSBURG VA CLINIC
EFFECTIVE DATE/TIME	2018-09-10 00:00:00 STATUS: ACTIVE NPI: 1003398728
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	688GF
IDENTIFIER	CODING SYSTEM: CLIA ID: 21D2153774