STAMFORD VA PRIMARY CARE CTR (865)    INSTITUTION (4)

Name Value
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