| NAME |
MADISON PHARMACY |
| STATE |
WISCONSIN |
| STREET ADDR. 1 |
2500 OVERLOOK TER |
| CITY |
MADISON |
| ZIP |
53705-2254 |
| OFFICIAL VA NAME |
Madison Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
MADISON VAMC PHARMACY |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1033177787
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2500 Overlook Terrace
- CITY (CHANGED FROM): Madison
- STATE (CHANGED FROM): WISCONSIN
- ZIP (CHANGED FROM): 53705-2254
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1033177787
|
