| NAME |
PRESCOTT PHARMACY |
| STATE |
ARIZONA |
| STREET ADDR. 1 |
500 North Highway 89 |
| CITY |
Prescott |
| ZIP |
86313-5001 |
| OFFICIAL VA NAME |
Prescott Pharmacy |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
PRESCOTT VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
500 North Highway 89 |
| CITY (MAILING) |
Prescott |
| STATE (MAILING) |
ARIZONA |
| ZIP (MAILING) |
86313-5001 |
| EFFECTIVE DATE/TIME |
-
- 2006-08-22 00:00:00
- STATUS: ACTIVE
- NPI: 1801854328
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| TIMEZONE EXCEPTION |
SST Only |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1801854328
|
