MARTINEZ CBOC PHARM (2820)    INSTITUTION (4)

Name Value
NAME MARTINEZ CBOC PHARM
STATE CALIFORNIA
STREET ADDR. 1 150 MUIR RD
CITY MARTINEZ
ZIP 94553-4668
OFFICIAL VA NAME Martinez Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MARTINEZ VAMC PHARMACY
ST. ADDR. 1 (MAILING) 150 MUIR RD
CITY (MAILING) MARTINEZ
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 94553-4668
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1356309017
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
HISTORY
  • STREET ADDR. 1 (CHANGED FROM):   150 Muir Rd.
    CITY (CHANGED FROM):   Martinez
    STATE (CHANGED FROM):   CALIFORNIA
    ZIP (CHANGED FROM):   94553-4668
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1356309017