SALT LAKE CITY VA MOBILE CLNIC (4629) INSTITUTION (4)

Name	Value
NAME	SALT LAKE CITY VA MOBILE CLNIC
STATE	UTAH
STREET ADDR. 1	500 FOOTHILL BLVD
CITY	SALT LAKE CITY
ZIP	84148-0001
OFFICIAL VA NAME	SALT LAKE CITY VA MOBILE CLNIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: GEORGE E. WAHLEN VAMC
BILLING FACILITY NAME	SALT LAKE CITY VA MOBILE CLNIC
EFFECTIVE DATE/TIME	2023-09-27 00:00:00 STATUS: ACTIVE NPI: 1326827593
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	MOUNTAIN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	660QE
HISTORY