MOUNTAIN HOME PHARMACY (2862)    INSTITUTION (4)

Name Value
NAME MOUNTAIN HOME PHARMACY
STATE TENNESSEE
STREET ADDR. 1 1 VETERANS WAY
CITY MOUNTAIN HOME
ZIP 37684-9998
OFFICIAL VA NAME Mountain Home Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MOUNTAIN HOME VAMC PHARMACY
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1548218266
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:   1548218266