| NAME |
LEO C. CHASE JR VA CLINIC |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
100 DEERFIELD PRESERVE BLVD |
| CITY |
SAINT AUGUSTINE |
| ZIP |
32086-5966 |
| OFFICIAL VA NAME |
LEO C. CHASE JR VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SAINT AUGUSTINE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1922041003
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
573GE |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1922041003
-
- CODING SYSTEM: VASTANUM
- ID: 573GE
-
- CODING SYSTEM: CLIA
- ID: 10D1001581
|
