WEST LA HCS (OUTPATIENT PHARM) (4183)    INSTITUTION (4)

Name Value
NAME WEST LA HCS (OUTPATIENT PHARM)
STATE CALIFORNIA
STREET ADDR. 1 11301 WILSHIRE BLVD
STREET ADDR. 2 11301 WILSHIRE BLVD
CITY LOS ANGELES
ZIP 90073-1003
OFFICIAL VA NAME WEST LA HCS OUTPATIENT PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME WEST LA VAMC PHARMACY
CITY (MAILING) LOS ANGELES
STATE (MAILING) CALIFORNIA
ZIP (MAILING) 90073-1003
EFFECTIVE DATE/TIME
  • 2008-02-04 00:00:00
    STATUS:   ACTIVE
    NPI:   1871541268
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA