FAYETTEVILLE AR PHARMACY (2854)    INSTITUTION (4)

Name Value
NAME FAYETTEVILLE AR PHARMACY
STATE ARKANSAS
STREET ADDR. 1 1100 N COLLEGE AVE
CITY Fayetteville
ZIP 72703-1944
OFFICIAL VA NAME Fayetteville AR Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME FAYETTEVILLE AR VAMC PHARMACY
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1508824434
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:   1508824434