| NAME |
BROCKTON PHARMACY |
| STATE |
MASSACHUSETTS |
| STREET ADDR. 1 |
940 BELMONT ST |
| CITY |
Brockton |
| ZIP |
02301-5596 |
| OFFICIAL VA NAME |
Brockton Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
BROCKTON VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
940 BELMONT ST |
| CITY (MAILING) |
Brockton |
| STATE (MAILING) |
MASSACHUSETTS |
| ZIP (MAILING) |
02301-5596 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1447218896
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1447218896
|
