FORT CAMPBELL VA CLINIC (4614) INSTITUTION (4)

Name	Value
NAME	FORT CAMPBELL VA CLINIC
STATE	KENTUCKY
STREET ADDR. 1	650 JOEL DR
CITY	FORT CAMPBELL
ZIP	42223-5318
OFFICIAL VA NAME	FORT CAMPBELL VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 9 PARENT FACILITY PARENT OF ASSOCIATION: TENNESSEE VALLEY HCS
BILLING FACILITY NAME	FORT CAMPBELL 2 VA CLINIC
EFFECTIVE DATE/TIME	2024-01-29 00:00:00 STATUS: ACTIVE NPI: 1013779453
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	626GQ
HISTORY