NORTHPORT PHARMACY (2880)    INSTITUTION (4)

Name Value
NAME NORTHPORT PHARMACY
STATE NEW YORK
STREET ADDR. 1 79 Middleville Rd.
CITY Northport
ZIP 11768-2200
OFFICIAL VA NAME Northport Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME NORTHPORT VAMC PHARMACY
ST. ADDR. 1 (MAILING) 79 Middleville Rd.
CITY (MAILING) Northport
STATE (MAILING) NEW YORK
ZIP (MAILING) 11768-2200
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1659339265
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:   1659339265