SAN JOSE PHARMACY (2847)    INSTITUTION (4)

Name Value
NAME SAN JOSE PHARMACY
STATE CALIFORNIA
STREET ADDR. 1 5855 SILVER CREEK VALLEY PLACE
CITY SAN JOSE
ZIP 95138-1059
OFFICIAL VA NAME San Jose Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SAN JOSE VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1487602025
  • 2022-07-07 00:00:00
    STATUS:   INACTIVE
    NPI:   1487602025
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:   1487602025