APPLETON OPC PHARMACY (4171)    INSTITUTION (4)

Name Value
NAME APPLETON OPC PHARMACY
STATE WISCONSIN
STREET ADDR. 1 10 TRI PARK WAY
CITY APPLETON
ZIP 54914-1658
OFFICIAL VA NAME APPLETON OPC PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME APPLETON VA CBOC PHARMACY
EFFECTIVE DATE/TIME
  • 2008-03-24 00:00:00
    STATUS:   ACTIVE
    NPI:   1669643912
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA