CANTON PHARMACY (4132)    INSTITUTION (4)

Name Value
NAME CANTON PHARMACY
STATE OHIO
STREET ADDR. 1 733 MARKET AVENUE S
CITY CANTON
ZIP 44702-2165
OFFICIAL VA NAME CANTON PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME CANTON VA CBOC PHARMACY
ST. ADDR. 1 (MAILING) 733 MARKET AVENUE S
CITY (MAILING) CANTON
STATE (MAILING) OHIO
ZIP (MAILING) 44702-2165
EFFECTIVE DATE/TIME
  • 2008-02-04 00:00:00
    STATUS:   ACTIVE
    NPI:   1154514644
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA