FREDERICKSBURG VA CLINIC (893) INSTITUTION (4)

Name	Value
NAME	FREDERICKSBURG VA CLINIC
STATE	VIRGINIA
STREET ADDR. 1	130 EXECUTIVE CTR PKWY
CITY	FREDERICKSBURG
ZIP	22401-3100
OFFICIAL VA NAME	FREDERICKSBURG VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 6 PARENT FACILITY PARENT OF ASSOCIATION: RICHMOND VA MEDICAL CENTER
BILLING FACILITY NAME	FREDERICKSBURG VA
EFFECTIVE DATE/TIME	2007-01-08 00:00:00 STATUS: ACTIVE NPI: 1093752099 2013-01-31 00:00:00 STATUS: ACTIVE NPI: 1093752099
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	652GA
IDENTIFIER	CODING SYSTEM: NPI ID: 1093752099 CODING SYSTEM: VASTANUM ID: 652GA CODING SYSTEM: CLIA ID: 49D0998351