NORTH FARGO VA CLINIC (4400) INSTITUTION (4)

Name	Value
NAME	NORTH FARGO VA CLINIC
STATE	NORTH DAKOTA
STREET ADDR. 1	721 FIRST AVENUE NORTH
CITY	FARGO
ZIP	58102-4903
OFFICIAL VA NAME	NORTH FARGO VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: FARGO VA HCS
BILLING FACILITY NAME	FARGO VA CLINIC
EFFECTIVE DATE/TIME	2020-05-15 00:00:00 STATUS: ACTIVE NPI: 1194358739
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	437QA
IDENTIFIER	CODING SYSTEM: CLIA ID: 35D2191755