SALT LAKE CITY PHARMACY (2866)    INSTITUTION (4)

Name Value
NAME SALT LAKE CITY PHARMACY
STATE UTAH
STREET ADDR. 1 500 Foothill Blvd.
CITY Salt Lake City
ZIP 84148-0001
OFFICIAL VA NAME Salt Lake City Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SALT LAKE CITY VAMC PHARMACY
ST. ADDR. 1 (MAILING) 500 Foothill Blvd.
CITY (MAILING) Salt Lake City
STATE (MAILING) UTAH
ZIP (MAILING) 84148-0001
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1558329722
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1558329722