| NAME |
MAYAGUEZ PHARMACY |
| STATE |
PUERTO RICO |
| STREET ADDR. 1 |
175 AVE ALGARROBO |
| CITY |
MAYAGUEZ |
| ZIP |
00682-6331 |
| OFFICIAL VA NAME |
MAYAGUEZ PHARMACY |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
MAYAGUEZ VA CLINIC PHARMACY |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1427016187
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
ATLANTIC |
| COUNTRY |
USA |
| TIMEZONE EXCEPTION |
SST Only |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 175 ALGARROBO AVENUE
- CITY (CHANGED FROM): MAYAGUEZ
- STATE (CHANGED FROM): PUERTO RICO
- ZIP (CHANGED FROM): 00682-6331
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1427016187
|
