MARTINSBURG PHARMACY (2876)    INSTITUTION (4)

Name Value
NAME MARTINSBURG PHARMACY
STATE WEST VIRGINIA
STREET ADDR. 1 510 Butler Ave
CITY Martinsburg
ZIP 25405-9990
OFFICIAL VA NAME Martinsburg Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME MARTINSBURG VAMC PHARMACY
ST. ADDR. 1 (MAILING) 510 Butler Ave
CITY (MAILING) Martinsburg
STATE (MAILING) WEST VIRGINIA
ZIP (MAILING) 25405-9990
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1629026414
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:   1629026414