| NAME |
LAWTON (OPC) |
| STATE |
OKLAHOMA |
| STREET ADDR. 1 |
4303 PITTMAN & THOMAS ROAD, BLDG 4303 |
| CITY |
Ft. Sill |
| ZIP |
73503-4473 |
| OFFICIAL VA NAME |
LAWTON/FT. SILL VA OUTPATIENT CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
LAWTON VA CBOC |
| ST. ADDR. 1 (MAILING) |
4303 PITTMAN & THOMAS ROAD, BLDG 4303 |
| CITY (MAILING) |
Ft. Sill |
| STATE (MAILING) |
OKLAHOMA |
| ZIP (MAILING) |
73503-4473 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1578506382
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
635GA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1578506382
-
- CODING SYSTEM: VASTANUM
- ID: 635GA
-
- CODING SYSTEM: CLIA
- ID: 37D0988013
|
