| NAME |
QUINCY |
| STATE |
MASSACHUSETTS |
| STREET ADDR. 1 |
110 WEST SQUANTAM ST |
| CITY |
QUINCY |
| ZIP |
02171-2122 |
| OFFICIAL VA NAME |
VA BOSTON HEALTHCARE SYSTEM - QUINCY CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
QUINCY VA CLINIC |
| ST. ADDR. 1 (MAILING) |
110 WEST SQUANTAM ST |
| CITY (MAILING) |
QUINCY |
| STATE (MAILING) |
MASSACHUSETTS |
| ZIP (MAILING) |
02171 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1730127952
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
523GC |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1730127952
-
- CODING SYSTEM: VASTANUM
- ID: 523GC
|
