| NAME |
SANTA ROSA CLINIC PHARMACY |
| STATE |
CALIFORNIA |
| STREET ADDR. 1 |
2285 CHALLENGER WAY |
| CITY |
SANTA ROSA |
| ZIP |
95407-9998 |
| OFFICIAL VA NAME |
SANTA ROSA CLINIC PHARMACY |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
SANTA ROSA VA CLINIC PHARMACY |
| EFFECTIVE DATE/TIME |
-
- 2008-02-04 00:00:00
- STATUS: ACTIVE
- NPI: 1497948442
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
PACIFIC |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 3841 BRICKWAY BLVD
- STREET ADDR. 2 (CHANGED FROM): 3315 CHANNATE ROAD
- CITY (CHANGED FROM): SANTA ROSA
- STATE (CHANGED FROM): CALIFORNIA
- ZIP (CHANGED FROM): 95403-8226
|
