NAME |
BRADENTON VA CLINIC |
STATE |
FLORIDA |
STREET ADDR. 1 |
5520 S.R. 64 |
CITY |
BRADENTON |
ZIP |
34208-5526 |
OFFICIAL VA NAME |
BRADENTON VA CLINIC |
STATUS |
National |
ASSOCIATIONS |
|
BILLING FACILITY NAME |
BRADENTON VA CBOC |
ST. ADDR. 1 (MAILING) |
5520 S.R. 64 |
CITY (MAILING) |
BRADENTON |
STATE (MAILING) |
FLORIDA |
ZIP (MAILING) |
34208-5526 |
EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1073560603
|
TAXONOMY CODE |
|
LOCATION TIMEZONE |
EASTERN |
COUNTRY |
USA |
AGENCY CODE |
VA |
POINTER TO AGENCY |
VA |
STATION NUMBER |
516GD |
IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1073560603
-
- CODING SYSTEM: VASTANUM
- ID: 516GD
-
- CODING SYSTEM: CLIA
- ID: 10D0999479
|