MEDICARE: MONTROSE VAMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332100000X	Department of Veterans Affairs (VA) Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3339783	OTHER	NY	NCPDP#

General Provider Information

NPI Number	:	1063460798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTROSE VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94442
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4442
Country	:	US
Telephone Number	:	717-277-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	2094 ALBANY POST RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1454
Country	:	US
Telephone Number	:	914-737-4400
Fax Number	:	914-788-4830

Authorized Official
Title or Position	:	NPI TEAM MEMBER
Name	:	ERIN DENISE POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	01/11/2023

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Practice Fax:

Directions to “MONTROSE VAMC ” Practice Location

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