SHAWNEE VA CLINIC (4618) INSTITUTION (4)

Name	Value
NAME	SHAWNEE VA CLINIC
STATE	OKLAHOMA
STREET ADDR. 1	3700 N KICKAPOO AVE STE 100
CITY	SHAWNEE
ZIP	74804-0007
OFFICIAL VA NAME	SHAWNEE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: OKLAHOMA CITY VAMC
BILLING FACILITY NAME	SHAWNEE VA CLINIC
EFFECTIVE DATE/TIME	2022-08-18 00:00:00 STATUS: ACTIVE NPI: 1003544586
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	635GK
HISTORY
IDENTIFIER	CODING SYSTEM: CLIA ID: 37D2270871