| NAME |
DETROIT PHARMACY |
| STATE |
MICHIGAN |
| STREET ADDR. 1 |
4646 John R St. |
| CITY |
Detroit |
| ZIP |
48201-1916 |
| OFFICIAL VA NAME |
Detroit Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
DETROIT VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
4646 John R St. |
| CITY (MAILING) |
Detroit |
| STATE (MAILING) |
MICHIGAN |
| ZIP (MAILING) |
48201-1916 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1184682007
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1184682007
|
