| Name | Value |
|---|---|
| PROVIDER TYPE | Other Service Providers |
| CLASSIFICATION | Military Health Care Provider |
| DEFINITION | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| STATUS | Active |
| VA CODE | V183407 |
| X12 CODE | 171000000X |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5253152 |
| EFFECTIVE DATE/TIME |
|