VA102066 (2068)    PLAN (366.03)

Name Value
ID VA102066
NAME ST JOHN PROV HOSP
NAME - SHORT ST JPH
REGION ALL
DATE/TIME CREATED 2004-02-13 22:59:59
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 003585
PROCESSOR CONTROL NUMBER (PCN) 23904
NCPDP PROCESSOR NAME MEDIMPACT
ENABLED? Yes
BILLING PAYER SHEET NAME MDMPCTB1
REVERSAL PAYER SHEET NAME MDMPCTB2
MAXIMUM NCPDP TRANSACTIONS 4
APPLICATION
  • E-PHARM
    NATIONAL ACTIVE?:   Active
    LOCAL ACTIVE?:   Not Active
    USER EDITED LOCAL:   INTERFACE,IB EIV
    DATE/TIME LOCAL EDITED:   2006-05-25 15:17:30
    DATE/TIME NATIONAL EDITED:   2004-02-15 13:06:42
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 13:06:42