NORTHERN INDIANA PHARMACY (2842)    INSTITUTION (4)

Name Value
NAME NORTHERN INDIANA PHARMACY
STATE INDIANA
STREET ADDR. 1 1700 East 38th St.
CITY Marion
ZIP 46952-4568
OFFICIAL VA NAME Northern Indiana Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MARION IN VAMC PHARMACY
ST. ADDR. 1 (MAILING) 1700 East 38th St.
CITY (MAILING) Marion
STATE (MAILING) INDIANA
ZIP (MAILING) 46952-4568
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1457309379
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1457309379