MOUNTAIN HOME VA CLINIC (835) INSTITUTION (4)

Name	Value
NAME	MOUNTAIN HOME VA CLINIC
STATE	ARKANSAS
STREET ADDR. 1	759 HIGHWAY 62 E SUITE 331
CITY	MTN HOME
ZIP	72653-3260
OFFICIAL VA NAME	MOUNTAIN HOME, AR CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: CENTRAL ARKANSAS HCS
BILLING FACILITY NAME	MOUNTAIN HOME VA CLINIC
EFFECTIVE DATE/TIME	2007-01-08 00:00:00 STATUS: ACTIVE NPI: 1063450617
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	598GA
IDENTIFIER	CODING SYSTEM: NPI ID: 1063450617 CODING SYSTEM: VASTANUM ID: 598GA