N COLLEGE AVE VA MOBILE CLINIC (4578) INSTITUTION (4)

Name	Value
NAME	N COLLEGE AVE VA MOBILE CLINIC
STATE	ARKANSAS
STREET ADDR. 1	1100 N COLLEGE AVE
CITY	FAYETTEVILLE
ZIP	72703-1944
OFFICIAL VA NAME	N COLLEGE AVE VA MOBILE CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: FAYETTEVILLE AR VAMC
BILLING FACILITY NAME	FAYETTEVILLE VA MOBILE CLINIC
EFFECTIVE DATE/TIME	2023-10-01 00:00:00 STATUS: ACTIVE NPI: 1063291961
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	564QC
HISTORY