Name | Value |
---|---|
PROVIDER TYPE | Ambulatory Health Care Facilities |
CLASSIFICATION | Clinic/Center |
AREA OF SPECIALIZATION | VA |
STATUS | Active |
X12 CODE | 261QV0200X |
INDIVIDUAL/NON | NON-INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5252282 |
EFFECTIVE DATE/TIME |
|