| NAME |
VALDOSTA VA CLINIC |
| STATE |
GEORGIA |
| STREET ADDR. 1 |
348 ENTERPRISE DR STE B |
| CITY |
VALDOSTA |
| ZIP |
31601-5169 |
| OFFICIAL VA NAME |
VALDOSTA VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
VALDOSTA VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1306886791
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
573GA |
| HISTORY |
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1306886791
-
- CODING SYSTEM: VASTANUM
- ID: 573GA
-
- CODING SYSTEM: CLIA
- ID: 11D1001568
|
