WILMINGTON NC VA CLINIC PHARM (4182)    INSTITUTION (4)

Name Value
NAME WILMINGTON NC VA CLINIC PHARM
STATE NORTH CAROLINA
STREET ADDR. 1 1705 GARDNER ROAD
CITY WILMINGTON
ZIP 28405-8873
OFFICIAL VA NAME WILMINGTON VA CBOC PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME WILMINGTON NC VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2013-02-05 00:00:00
    STATUS:   ACTIVE
    NPI:   1831438381
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA