STUART VA CLINIC (1325)    INSTITUTION (4)

Name Value
NAME STUART VA CLINIC
STATE FLORIDA
STREET ADDR. 1 3501 S E WILLOUGHBY BLVD
CITY STUART
ZIP 34997-5059
OFFICIAL VA NAME STUART VA CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME STUART VA CBOC
ST. ADDR. 1 (MAILING) 3501 S E WILLOUGHBY BLVD
CITY (MAILING) STUART
STATE (MAILING) FLORIDA
ZIP (MAILING) 34997-5059
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1154360162
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 548GC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1154360162
  • CODING SYSTEM:   VASTANUM
    ID:   548GC