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NPI Code Detail

MEDICARE: GRAND JUNCTION VAMC

MEDICARE: GRAND JUNCTION 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
1332100000XDepartment of Veterans Affairs (VA) Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10617728OTHERCONCPDP#

General Provider Information

NPI Number : 1093773988
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAND JUNCTION VAMC
Provider Business Mailing Address
First Line : PO BOX 94457
Second Line :
City : CLEVELAND
State : OH
Zip : 44101-4457
Country : US
Telephone Number : 913-578-4409
Fax Number :
Provider Business Practice Location Address
First Line : 2121 NORTH AVE
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-6428
Country : US
Telephone Number : 970-263-2800
Fax Number : 970-263-2801
Authorized Official
Title or Position : NPI TEAM MEMBER
Name : ERIN DENISE POTTER
Credential :
Telephone Number : 202-382-2579
Provider Enumeration Date : 05/02/2006
Last Update Date : 03/28/2023

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1407806441 — GRAND JUNCTION VAMC
Practice Location Address:
2121 NORTH AVE
GRAND JUNCTION, CO
81501-6428
Practice Phone: 913-578-4409
Practice Fax:

Directions to “GRAND JUNCTION VAMC ” Practice Location

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