| NAME |
LAKELAND VA CLINIC (673QC) |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
4231 SOUTH PIPKIN RD |
| CITY |
LAKELAND |
| ZIP |
33811-1442 |
| OFFICIAL VA NAME |
LAKELAND VA CLINIC (673QC) |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
LAKELAND VA OOS |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1811944796
-
- 2014-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1922406180
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
673QC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1811944796
-
- CODING SYSTEM: VASTANUM
- ID: 673GB
-
- CODING SYSTEM: CLIA
- ID: 10D1001497
|
