| NAME |
ZZ-GULFPORT VAMC PHARMACY |
| STATE |
MISSISSIPPI |
| STREET ADDR. 1 |
200 E. BEACH BLVD, BLDG 2 RM 110 |
| CITY |
GULFPORT |
| ZIP |
39507-1005 |
| OFFICIAL VA NAME |
GULFPORT PHARMACY |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| BILLING FACILITY NAME |
GULFPORT VAMC PHARMACY |
| ST. ADDR. 1 (MAILING) |
200 E. BEACH BLVD, BLDG 2 RM 110 |
| CITY (MAILING) |
GULFPORT |
| STATE (MAILING) |
MISSISSIPPI |
| ZIP (MAILING) |
39507-1005 |
| EFFECTIVE DATE/TIME |
-
- 2007-09-27 00:00:00
- STATUS: ACTIVE
- NPI: 1689622771
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
