FORT WORTH PHARMACY (2846)    INSTITUTION (4)

Name Value
NAME FORT WORTH PHARMACY
STATE TEXAS
STREET ADDR. 1 2201 SE LOOP 820
CITY Fort Worth
ZIP 76119-5863
OFFICIAL VA NAME Fort Worth Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME FORT WORTH VA CLINIC PHARMACY
ST. ADDR. 1 (MAILING) 2201 SE LOOP 820
CITY (MAILING) Fort Worth
STATE (MAILING) TEXAS
ZIP (MAILING) 76119-5863
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1477511368
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1477511368