LOS ANGELES ACC METH PHARMACY (4138)    INSTITUTION (4)

Name Value
NAME LOS ANGELES ACC METH PHARMACY
STATE CALIFORNIA
STREET ADDR. 1 351 E. TEMPLE ST.
STREET ADDR. 2 351 E. TEMPLE ST.
CITY LOS ANGELES
ZIP 90012-3328
OFFICIAL VA NAME LOS ANGELES ACC METH PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME LOS ANGELES VA CBOC METHADONE PHARMACY
CITY (MAILING) LOS ANGELES
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 90012-3328
EFFECTIVE DATE/TIME
  • 2008-02-04 00:00:00
    STATUS:   ACTIVE
    NPI:   1235187683
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA