TULSA ELEVENTH ST VA CLINIC (3804) INSTITUTION (4)

Name	Value
NAME	TULSA ELEVENTH ST VA CLINIC
STATE	OKLAHOMA
STREET ADDR. 1	10159 EAST 11ST STREET
CITY	TULSA
ZIP	74128-3058
OFFICIAL VA NAME	TULSA ELEVENTH ST VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: JACK C. MONTGOMERY VAMC
BILLING FACILITY NAME	TULSA ELEVENTH ST VA CLINIC
EFFECTIVE DATE/TIME	2014-10-01 00:00:00 STATUS: ACTIVE NPI: 1316335664
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
STATION NUMBER	623QB