MOUNTAIN HOME VA MOBILE CLINIC (4611)    INSTITUTION (4)

Name Value
NAME MOUNTAIN HOME VA MOBILE CLINIC
STATE TENNESSEE
STREET ADDR. 1 CORNER OF LAMONT AND VETERANS WAY
CITY MOUNTAIN HOME
ZIP 37684-9998
OFFICIAL VA NAME MOUNTAIN HOME VA MOBILE CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MOUNTAIN HOME VA MOBILE CLINIC
EFFECTIVE DATE/TIME
  • 2023-10-01 00:00:00
    STATUS:   ACTIVE
    NPI:   1952180846
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 621QI
HISTORY