BOWLING GREEN (833)    INSTITUTION (4)

Name Value
NAME BOWLING GREEN
STATE KENTUCKY
STREET ADDR. 1 600 US 31 WEST BYPASS, SUITE #12
STREET ADDR. 2 HEARTLAND MEDICAL PLAZA
CITY BOWLING GREEN
ZIP 42101-4905
OFFICIAL VA NAME BOWLING GREEN COMMUNITY BASED OUTPATIENT CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME BOWLING GREEN VA CLINIC
ST. ADDR. 1 (MAILING) 1110 WILKINSON TRACE CIRCLE
ST. ADDR. 2 (MAILING) HEARTLAND MEDICAL PLAZA
CITY (MAILING) BOWLING GREEN
STATE (MAILING) KENTUCKY
ZIP (MAILING) 42103-3402
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1639120215
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 626GC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1639120215
  • CODING SYSTEM:   VASTANUM
    ID:   626GC