| NAME |
CANANDAIGUA PHARMACY |
| STATE |
NEW YORK |
| STREET ADDR. 1 |
400 FORT HILL AVE (119-B) |
| CITY |
Canandaigua |
| ZIP |
14424-1159 |
| OFFICIAL VA NAME |
Canandaigua Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
CANANDAIGUA VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
400 FORT HILL AVE (119-B) |
| CITY (MAILING) |
Canandaigua |
| STATE (MAILING) |
NEW YORK |
| ZIP (MAILING) |
14424-1159 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1164480273
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1164480273
|