FRESNO PHARMACY (2823)    INSTITUTION (4)

Name Value
NAME FRESNO PHARMACY
STATE CALIFORNIA
STREET ADDR. 1 2615 East Clinton Ave.
CITY Fresno
ZIP 93703-2223
OFFICIAL VA NAME Fresno Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME FRESNO VAMC PHARMACY
ST. ADDR. 1 (MAILING) 2615 East Clinton Ave.
CITY (MAILING) Fresno
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 93703-2223
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1366400244
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1366400244