FOURTEENTH STREET VA CLINIC (4474) INSTITUTION (4)

Name	Value
NAME	FOURTEENTH STREET VA CLINIC
STATE	OKLAHOMA
STREET ADDR. 1	1301 NORTHEAST 14TH STREET
CITY	OKLAHOMA CITY
ZIP	73117-2018
OFFICIAL VA NAME	FOURTEENTH STREET VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: OKLAHOMA CITY VAMC
BILLING FACILITY NAME	OKLAHOMA CITY 1 VA CLINIC
EFFECTIVE DATE/TIME	2018-10-26 00:00:00 STATUS: ACTIVE NPI: 1104308824
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	635QC
IDENTIFIER	CODING SYSTEM: CLIA ID: 37D2171343