TOMAH PHARMACY (2872)    INSTITUTION (4)

Name Value
NAME TOMAH PHARMACY
STATE WISCONSIN
STREET ADDR. 1 500 East Veterans St.
CITY Tomah
ZIP 54660-3105
OFFICIAL VA NAME Tomah Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME TOMAH VAMC PHARMACY
ST. ADDR. 1 (MAILING) 500 East Veterans St.
CITY (MAILING) Tomah
STATE (MAILING) WISCONSIN
ZIP (MAILING) 54660-3105
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1598713778
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:   1598713778