PHOENIX PHARMACY (2789)    INSTITUTION (4)

Name Value
NAME PHOENIX PHARMACY
STATE ARIZONA
STREET ADDR. 1 650 East Indian School Rd.
CITY Phoenix
ZIP 85012-1839
OFFICIAL VA NAME Phoenix Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME PHOENIX VAMC PHARMACY
ST. ADDR. 1 (MAILING) 650 East Indian School Rd.
CITY (MAILING) Phoenix
STATE (MAILING) ARIZONA
ZIP (MAILING) 85012-1839
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1184682676
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
TIMEZONE EXCEPTION SST Only
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1184682676