SOUTH CHARLOTTE VA CLINIC (3962) INSTITUTION (4)

Name	Value
NAME	SOUTH CHARLOTTE VA CLINIC
STATE	NORTH CAROLINA
STREET ADDR. 1	3506 W. TYVOLA RD
CITY	CHARLOTTE
ZIP	28208-9998
OFFICIAL VA NAME	SOUTH CHARLOTTE VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 6 PARENT FACILITY PARENT OF ASSOCIATION: W.G. HEFNER SALISBURY VAMC
BILLING FACILITY NAME	CHARLOTTE 1 VA CLINIC
EFFECTIVE DATE/TIME	2016-01-28 00:00:00 STATUS: ACTIVE NPI: 1457719312
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	659BZ
IDENTIFIER	CODING SYSTEM: CLIA ID: 34D2114475