Pharmacy Service Providers (1617)    PERSON CLASS (8932.1)

Name Value
PROVIDER TYPE Pharmacy Service Providers
CLASSIFICATION Fellow, Pharmacist
STATUS Active
VA CODE V090112
X12 CODE 390200000X
INDIVIDUAL/NON INDIVIDUAL
MASTER ENTRY FOR VUID YES
VUID 5330384
EFFECTIVE DATE/TIME
  • 2019-10-01 08:25:05
    STATUS:   ACTIVE