| NAME |
FARGO PHARMACY |
| STATE |
NORTH DAKOTA |
| STREET ADDR. 1 |
2101 ELM ST N |
| CITY |
FARGO |
| ZIP |
58102-2417 |
| OFFICIAL VA NAME |
Fargo Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
FARGO VAMC PHARMACY |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1700844636
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2101 Elm St.
- CITY (CHANGED FROM): Fargo
- STATE (CHANGED FROM): NORTH DAKOTA
- ZIP (CHANGED FROM): 58102-2417
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1700844636
|
