WICHITA PHARMACY (2812)    INSTITUTION (4)

Name Value
NAME WICHITA PHARMACY
STATE KANSAS
STREET ADDR. 1 5500 East Kellogg
CITY Wichita
ZIP 67218-1607
OFFICIAL VA NAME Wichita Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME WICHITA VAMC PHARMACY
ST. ADDR. 1 (MAILING) 5500 East Kellogg
CITY (MAILING) Wichita
STATE (MAILING) KANSAS
ZIP (MAILING) 67218-1607
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1316995517
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:   1316995517