| NAME |
ZZ-DORCHESTER |
| STATE |
MASSACHUSETTS |
| STREET ADDR. 1 |
895 BLUE HILL AVE |
| CITY |
DORCHESTER |
| ZIP |
02121-2902 |
| OFFICIAL VA NAME |
VA BOSTON HEALTHCARE SYSTEM - DORCHESTER CBOC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
DORCHESTER VA CBOC |
| ST. ADDR. 1 (MAILING) |
895 BLUE HILL AVE |
| CITY (MAILING) |
DORCHESTER |
| STATE (MAILING) |
MASSACHUSETTS |
| ZIP (MAILING) |
02121-2902 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1639122104
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
523GE |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1639122104
-
- CODING SYSTEM: VASTANUM
- ID: 523GE
-
- CODING SYSTEM: CLIA
- ID: 22D1012837
|
