| NAME |
ST. LOUIS MO CBOC |
| STATE |
MISSOURI |
| STREET ADDR. 1 |
6854 PARKER ROAD |
| CITY |
FLORISSANT |
| ZIP |
63033-5313 |
| OFFICIAL VA NAME |
ST LOUIS COUNTY VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ST. LOUIS VA CBOC |
| ST. ADDR. 1 (MAILING) |
6854 PARKER ROAD |
| CITY (MAILING) |
FLORISSANT |
| STATE (MAILING) |
MISSOURI |
| ZIP (MAILING) |
63033-5313 |
| EFFECTIVE DATE/TIME |
-
- 2007-11-27 00:00:00
- STATUS: ACTIVE
- NPI: 1518155878
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
657GB |
| IDENTIFIER |
-
- CODING SYSTEM: VASTANUM
- ID: 657GB
-
- CODING SYSTEM: CLIA
- ID: 26D1024925
|
