CHARLOTTE 1 VA CLINIC PHARMACY (4142)    INSTITUTION (4)

Name Value
NAME CHARLOTTE 1 VA CLINIC PHARMACY
STATE NORTH CAROLINA
STREET ADDR. 1 3506 W TYVOLA ROAD
CITY CHARLOTTE
ZIP 28208-9998
OFFICIAL VA NAME CHARLOTTE 1 VA CLINIC PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME CHARLOTTE 1 VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2016-04-04 00:00:00
    STATUS:   ACTIVE
    NPI:   1245693050
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA