| NAME |
ZZ FT CAMPBELL CBOC |
| STATE |
KENTUCKY |
| STREET ADDR. 1 |
DESERT STORM AVE. BUILDING 6139 |
| CITY |
FORT CAMPBELL |
| ZIP |
42223-5564 |
| OFFICIAL VA NAME |
HOPKINSVILLE COMMUNITY BASED OUTPATIENT CLINIC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FORT CAMPBELL VA CBOC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1457306912
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
626GD |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1457306912
-
- CODING SYSTEM: VASTANUM
- ID: 626GD
-
- CODING SYSTEM: CLIA
- ID: 18D0326126
|
