| 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 |
|
| 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 |
|
| 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
|
