TYLER VA CLINIC PHARMACY (4521)    INSTITUTION (4)

Name Value
NAME TYLER VA CLINIC PHARMACY
STATE TEXAS
STREET ADDR. 1 428 CENTENNIAL PKWY
CITY TYLER
ZIP 75703-7166
OFFICIAL VA NAME TYLER VA CLINIC PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME TYLER VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2022-01-19 00:00:00
    STATUS:   ACTIVE
    NPI:   1942952072
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA