LAKE BALDWIN CBOC PHARMACY (4168)    INSTITUTION (4)

Name Value
NAME LAKE BALDWIN CBOC PHARMACY
STATE FLORIDA
STREET ADDR. 1 5201 RAYMOND ST
CITY ORLANDO
ZIP 32803-8208
OFFICIAL VA NAME LAKE BALDWIN CBOC PHARMACY
STATUS National
BILLING FACILITY NAME ORLANDO VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2013-09-11 00:00:00
    STATUS:   ACTIVE
    NPI:   1558796409
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA