WHITE CITY PHARMACY (2885)    INSTITUTION (4)

Name Value
NAME WHITE CITY PHARMACY
STATE OREGON
STREET ADDR. 1 8495 CRATER LAKE HWY
CITY White City
ZIP 97503-3011
OFFICIAL VA NAME White City Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME WHITE CITY VAMC PHARMACY
ST. ADDR. 1 (MAILING) 8495 CRATER LAKE HWY
CITY (MAILING) White City
STATE (MAILING) OREGON
ZIP (MAILING) 97503-3011
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1700834900
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
HISTORY
  • STREET ADDR. 1 (CHANGED FROM):   8495 Crater Lake Hwy.
    CITY (CHANGED FROM):   White City
    STATE (CHANGED FROM):   OREGON
    ZIP (CHANGED FROM):   97470-3011
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1700834900