MEDICARE: MONTGOMERY 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	0141123	OTHER		NCPDP

General Provider Information

NPI Number	:	1265898670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY VAMC

Provider Business Mailing Address
First Line	:	PO BOX 89470
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-6470
Country	:	US
Telephone Number	:	828-257-2333
Fax Number	:

Provider Business Practice Location Address
First Line	:	8105 VETERANS WAY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-9998
Country	:	US
Telephone Number	:	334-272-4670
Fax Number	:	334-395-2328

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

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	05/22/2024

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Directions to “MONTGOMERY VAMC ” Practice Location

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