ZZ-SOUTH BRONX CBOC (894)    INSTITUTION (4)

Name Value
NAME ZZ-SOUTH BRONX CBOC
STATE NEW YORK
STREET ADDR. 1 953 SOUTHERN BLVD.
CITY BRONX
ZIP 10459
OFFICIAL VA NAME SOUTH BRONX CLINIC
INACTIVE FACILITY FLAG INACTIVE
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SOUTH BRONX VA CBOC
ST. ADDR. 1 (MAILING) 953 SOUTHERN BLVD.
CITY (MAILING) BRONX
STATE (MAILING) NEW YORK
ZIP (MAILING) 10459
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1689614018
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 526GC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1689614018
  • CODING SYSTEM:   VASTANUM
    ID:   526GC
  • CODING SYSTEM:   CLIA
    ID:   33D1046041