CROWN POINT PHARMACY (2914)    INSTITUTION (4)

Name Value
NAME CROWN POINT PHARMACY
STATE INDIANA
STREET ADDR. 1 9330 SOUTH BROADWAY
CITY Crown Point
ZIP 46307-9830
OFFICIAL VA NAME Crown Point Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME CROWN POINT VA CBOC PHARMACY
ST. ADDR. 1 (MAILING) 9330 SOUTH BROADWAY
CITY (MAILING) Crown Point
STATE (MAILING) INDIANA
ZIP (MAILING) 46307-9830
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1821046848
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1821046848