| Name | Value |
|---|---|
| NAME | BLACKWELL CBOC |
| STATE | OKLAHOMA |
| STREET ADDR. 1 | 1009 W. FERGUSON AVE |
| STREET ADDR. 2 | BLACKWELL FAMILY MEDICINE |
| CITY | BLACKWELL |
| ZIP | 74631-5602 |
| OFFICIAL VA NAME | BLACKWELL CBOC |
| STATUS | National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME | BLACKWELL VA CBOC |
| ST. ADDR. 1 (MAILING) | 1009 W. FERGUSON AVE |
| ST. ADDR. 2 (MAILING) | BLACKWELL FAMILY MEDICINE |
| CITY (MAILING) | BLACKWELL |
| STATE (MAILING) | OKLAHOMA |
| ZIP (MAILING) | 74631-5602 |
| EFFECTIVE DATE/TIME |
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE | CENTRAL |
| COUNTRY | USA |
| AGENCY CODE | VA |
| POINTER TO AGENCY | VA |
| STATION NUMBER | 635GC |
| IDENTIFIER |
|