| NAME |
ROSEBURG PHARMACY |
| STATE |
OREGON |
| STREET ADDR. 1 |
913 NW GARDEN VALLEY BLVD |
| CITY |
Roseburg |
| ZIP |
97471-6523 |
| OFFICIAL VA NAME |
Roseburg Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
ROSEBURG VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
913 NW GARDEN VALLEY BLVD |
| CITY (MAILING) |
Roseburg |
| STATE (MAILING) |
OREGON |
| ZIP (MAILING) |
97471-6523 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1003874546
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 913 NW Garden Valley Blvd.
- CITY (CHANGED FROM): Roseburg
- STATE (CHANGED FROM): OREGON
- ZIP (CHANGED FROM): 97470-6253
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1003874546
|
