CROASDAILE VA CLINIC (4577) INSTITUTION (4)

Name	Value
NAME	CROASDAILE VA CLINIC
STATE	NORTH CAROLINA
STREET ADDR. 1	3114 CROASDAILE DR
CITY	DURHAM
ZIP	27705-2508
OFFICIAL VA NAME	CROASDAILE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 6 PARENT FACILITY PARENT OF ASSOCIATION: DURHAM VA MEDICAL CENTER
BILLING FACILITY NAME	DURHAM 1 VA CLINIC
EFFECTIVE DATE/TIME	2023-06-29 00:00:00 STATUS: ACTIVE NPI: 1326725672
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	558GI
HISTORY
IDENTIFIER	CODING SYSTEM: CLIA ID: 34D2284001