GRAND ISLAND PHARMACY (2921)    INSTITUTION (4)

Name Value
NAME GRAND ISLAND PHARMACY
STATE NEBRASKA
STREET ADDR. 1 2201 N. BROADWELL AVE
CITY GRAND ISLAND
ZIP 68803-2153
OFFICIAL VA NAME GRAND ISLAND PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME GRAND ISLAND VAMC PHARMACY
ST. ADDR. 1 (MAILING) 2201 N. BROADWELL AVE
CITY (MAILING) GRAND ISLAND
STATE (MAILING) NEBRASKA
ZIP (MAILING) 68803-2153
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1841258720
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:   1841258720