| NAME |
SHELBYVILLE VA CLINIC |
| STATE |
INDIANA |
| STREET ADDR. 1 |
2158 INTELLIPLEX DR STE 200 |
| CITY |
SHELBYVILLE |
| ZIP |
46176-8549 |
| OFFICIAL VA NAME |
SHELBYVILLE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SHELBYVILLE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2018-04-02 00:00:00
- STATUS: ACTIVE
- NPI: 1235625088
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
583GG |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 30 WEST RAMPART STREET
- CITY (CHANGED FROM): SHELBYVILLE
- STATE (CHANGED FROM): INDIANA
- ZIP (CHANGED FROM): 46176-8846
|
