| Name | Value |
|---|---|
| PROVIDER TYPE | Suppliers |
| CLASSIFICATION | Pharmacy |
| DEFINITION | A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| AREA OF SPECIALIZATION | Long Term Care Pharmacy |
| STATUS | Active |
| X12 CODE | 3336L0003X |
| SPECIALTY CODE | A5 |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5255528 |
| EFFECTIVE DATE/TIME |
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