LEAVENWORTH CMOP (976)    INSTITUTION (4)

Name Value
NAME LEAVENWORTH CMOP
STATE KANSAS
STREET ADDR. 1 5000 SOUTH 13TH ST.
CITY LEAVENWORTH
ZIP 66048-5581
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LEAVENWORTH - VA CMOP
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1316995186
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 760
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1316995186
  • CODING SYSTEM:   VASTANUM
    ID:   760