MENLO PARK PHARMACY (2763)    INSTITUTION (4)

Name Value
NAME MENLO PARK PHARMACY
STATE CALIFORNIA
STREET ADDR. 1 795 Willow Rd.
CITY Menlo Park
ZIP 94025-2539
OFFICIAL VA NAME Menlo Park Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MENLO PARK VAMC PHARMACY
ST. ADDR. 1 (MAILING) 795 Willow Rd.
CITY (MAILING) Menlo Park
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 94025-2539
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1043268048
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1043268048