| NAME |
ZZ-EUREKA CLINIC PHARMACY |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
714 F STREET |
| STREET ADDR. 2 |
727 E STREET |
| CITY |
EUREKA |
| ZIP |
95501-1036 |
| OFFICIAL VA NAME |
EUREKA CLINIC PHARMACY |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
EUREKA VA CBOC PHARMACY |
| ST. ADDR. 1 (MAILING) |
714 F STREET |
| CITY (MAILING) |
EUREKA |
| STATE (MAILING) |
CALIFORNIA |
| ZIP (MAILING) |
95501-1036 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1689632366
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 714 F STREET
- STREET ADDR. 2 (CHANGED FROM): 727 E STREET
- CITY (CHANGED FROM): EUREKA
- STATE (CHANGED FROM): CALIFORNIA
- ZIP (CHANGED FROM): 95501-1036
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1689632366
|
