NORTHWEST LAS VEGAS CBOC PHARM (4186)    INSTITUTION (4)

Name Value
NAME NORTHWEST LAS VEGAS CBOC PHARM
STATE NEVADA
STREET ADDR. 1 3968 N RANCHO DRIVE
CITY LAS VEGAS
ZIP 89130
OFFICIAL VA NAME NORTHWEST LAS VEGAS CBOC PHARM
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME NORTHWEST LAS VEGAS VA CBOC PHARM
EFFECTIVE DATE/TIME
  • 2011-09-06 00:00:00
    STATUS:   ACTIVE
    NPI:   1891079984
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE PACIFIC
COUNTRY USA