| Name | Value |
|---|---|
| PROVIDER TYPE | Hospitals |
| CLASSIFICATION | General Acute Care Hospital |
| AREA OF SPECIALIZATION | Children |
| STATUS | Active |
| X12 CODE | 282NC2000X |
| SPECIALTY CODE | A0 |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252687 |
| EFFECTIVE DATE/TIME |
|