| NAME | 
STAMFORD VA PRIMARY CARE CTR | 
| STATE | 
CONNECTICUT | 
| STREET ADDR. 1 | 
1275 SUMMER ST, SUITE 102 | 
| CITY | 
STAMFORD | 
| ZIP | 
06905-5359 | 
| OFFICIAL VA NAME | 
STAMFORD VA PRIMARY CARE CTR | 
| STATUS | 
National | 
| ASSOCIATIONS | 
 | 
| BILLING FACILITY NAME | 
STAMFORD VA CBOC | 
| ST. ADDR. 1 (MAILING) | 
1275 SUMMER ST, SUITE 102 | 
| CITY (MAILING) | 
STAMFORD | 
| STATE (MAILING) | 
CONNECTICUT | 
| ZIP (MAILING) | 
06905-5359 | 
| EFFECTIVE DATE/TIME | 
- 
- 2007-03-26 00:00:00
 
- STATUS:    ACTIVE
 
- NPI:    1255484796
 
 
 
 | 
| TAXONOMY CODE | 
 | 
| LOCATION TIMEZONE | 
EASTERN | 
| COUNTRY | 
USA | 
| AGENCY CODE | 
VA | 
| POINTER TO AGENCY | 
VA | 
| STATION NUMBER | 
689GB | 
| IDENTIFIER | 
- 
- CODING SYSTEM:    VASTANUM
 
- ID:    689GB
 
 
- 
- CODING SYSTEM:    CLIA
 
- ID:    07D1010385
 
 
 
 |