ST. CLOUD PHARMACY (2794)    INSTITUTION (4)

Name Value
NAME ST. CLOUD PHARMACY
STATE MINNESOTA
STREET ADDR. 1 4801 VETERANS DR.
CITY St. Cloud
ZIP 56303-2015
OFFICIAL VA NAME St. Cloud Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME ST. CLOUD VAMC PHARMACY
ST. ADDR. 1 (MAILING) 4801 VETERANS DR.
CITY (MAILING) St. Cloud
STATE (MAILING) MINNESOTA
ZIP (MAILING) 56303-2015
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1235187741
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1235187741