CHICAGO VAMC PHARMACY (4161)    INSTITUTION (4)

Name Value
NAME CHICAGO VAMC PHARMACY
STATE ILLINOIS
STREET ADDR. 1 820 S DAMEN AVE
CITY Chicago
ZIP 60612-3728
OFFICIAL VA NAME Chicago Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME CHICAGO VAMC PHARMACY
EFFECTIVE DATE/TIME
  • 2007-09-27 00:00:00
    STATUS:   ACTIVE
    NPI:   1518915172
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA