ALEXANDRIA VA MOBILE CLINIC (4546) INSTITUTION (4)

Name	Value
NAME	ALEXANDRIA VA MOBILE CLINIC
STATE	LOUISIANA
STREET ADDR. 1	2495 SHREVEPORT HWY
CITY	PINEVILLE
ZIP	71360-4044
OFFICIAL VA NAME	ALEXANDRIA VA MOBILE CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: ALEXANDRIA VA MEDICAL CENTER
BILLING FACILITY NAME	PINEVILLE VA MOBILE CLINIC
EFFECTIVE DATE/TIME	2023-08-07 00:00:00 STATUS: ACTIVE NPI: 1114600145
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	502QC
HISTORY