PHILADELPHIA PHARMACY (2777)    INSTITUTION (4)

Name Value
NAME PHILADELPHIA PHARMACY
STATE PENNSYLVANIA
STREET ADDR. 1 University & Woodland Ave.
CITY Philadelphia
ZIP 19104-4551
OFFICIAL VA NAME Philadelphia Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME PHILADELPHIA VAMC PHARMACY
ST. ADDR. 1 (MAILING) University & Woodland Ave.
CITY (MAILING) Philadelphia
STATE (MAILING) PENNSYLVANIA
ZIP (MAILING) 19104-4551
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1124077144
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1124077144