MASSAPONAX VA CLINIC (4486) INSTITUTION (4)

Name	Value
NAME	MASSAPONAX VA CLINIC
STATE	VIRGINIA
STREET ADDR. 1	4830 SOUTHPOINT DR
CITY	FREDERICKSBURG
ZIP	22407-2606
OFFICIAL VA NAME	MASSAPONAX VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 6 PARENT FACILITY PARENT OF ASSOCIATION: RICHMOND VA MEDICAL CENTER
BILLING FACILITY NAME	FREDERICKSBURG 2 VA CLINIC
EFFECTIVE DATE/TIME	2021-05-25 00:00:00 STATUS: ACTIVE NPI: 1720653306
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	652GI