TERRE HAUTE VA CLINIC PHARMACY (4523)    INSTITUTION (4)

Name Value
NAME TERRE HAUTE VA CLINIC PHARMACY
STATE INDIANA
STREET ADDR. 1 5080 E BILL FARR DR
CITY TERRE HAUTE
ZIP 47803-9324
OFFICIAL VA NAME TERRE HAUTE VA CLINIC PHARMACY
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME TERRE HAUTE VA CLINIC PHARMACY
EFFECTIVE DATE/TIME
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE
    NPI:   1992475206
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
HISTORY
  • STREET ADDR. 1 (CHANGED FROM):   5080 E BILL FARR DR
    CITY (CHANGED FROM):   TERRE HAUTE
    STATE (CHANGED FROM):   INDIANA
    ZIP (CHANGED FROM):   47803-9998