MADISON EAST VA CLINIC (4598) INSTITUTION (4)

Name	Value
NAME	MADISON EAST VA CLINIC
STATE	WISCONSIN
STREET ADDR. 1	4904 EASTPARK BLVD
CITY	MADISON
ZIP	53718-9998
OFFICIAL VA NAME	MADISON EAST VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 12 PARENT FACILITY PARENT OF ASSOCIATION: WILLIAM S. MIDDLETON VAMC
BILLING FACILITY NAME	MADISON 1 VA CLINIC
EFFECTIVE DATE/TIME	2024-02-26 00:00:00 STATUS: ACTIVE NPI: 1477319598
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	607GH
HISTORY
IDENTIFIER	CODING SYSTEM: CLIA ID: 52D2305017